Incidence, predictive factors, and clinical impact of stent recoil in stent fracture lesion after drug-eluting stent implantation

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• 作者：Masanobu Ohya ; Kazushige Kadota ; ^{k-kadota@lapis.plala.or.jp" class="auth_mail" title="E-mail the corresponding author} ; Shunsuke Kubo ; Takeshi Tada ; Seiji Habara ; Takenobu Shimada ; Hidewo Amano ; Yu Izawa ; Yusuke Hyodo ; Suguru Otsuru ; Daiji Hasegawa ; Hiroyuki Tanaka ; Yasushi Fuku ; Tsuyoshi Goto ; Kazuaki Mitsudo
• 关键词：Percutaneous coronary intervention ; Drug-eluting stent ; Stent fracture ; Stent deformation
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：1 July 2016
• 年：2016
• 卷：214
• 期：Complete
• 页码：123-129
• 全文大小：1046 K

文摘

Stent fracture (SF) after drug-eluting stent (DES) implantation was reported to be associated with target lesion revascularization (TLR). We have noted abnormal late acquired stent axial deformation in lesions after DES implantation, especially in SF lesions, and defined it as stent recoil (SR). We evaluated the incidence, predictive factors, and clinical impact of SR in SF lesions.

Methods

Between 2003 and 2012, 5456 patients (11,712 lesions) underwent DES implantations and follow-up angiography within one year after the index procedure. SR was defined as an axial recoil deformation less than 80% of the stent diameter and SF was defined as the separation of stent segments or stent struts. SF and SR were confirmed by follow-up angiography. The primary endpoint was defined as clinically driven TLR.

Results

SF was observed in 494 lesions (4.2%) and SR in 138 of SF lesions (27.9%). According to multinomial logistic regression analyses, severe calcification and ostial lesion in the right coronary artery were stronger predictive factors of SF with SR lesions. The cumulative incidences of any and clinically driven TLR at 5 years were both significantly higher in the SF with SR group than in the SF without SR group (51.7% versus 35.0%, P < 0.001; 22.2% versus 12.8%, P = 0.019; respectively).

Conclusions

SR in SF lesions after DES implantation could be related to the lesion characteristics. SF with SR was highly associated with subsequent TLR compared with SF without SR.