Predictors and Prognosis of Stent Fracture After Sirolimus-Eluting Stent Implantation

Abstract

Background: Stent fracture is a cause of in-stent restenosis (ISR) after sirolimus-eluting stent (SES) implantation, so this study investigated the incidence, predictors and prognosis of stent fracture. Methods and Results: The 273 consecutive patients (364 lesions) after SES implantation and who had 6-9 month' scheduled follow-up coronary angiography (CAG) were divided into groups with and without stent fracture. Δangle was defined as the difference in the angle in the target lesion between diastole and systole before the procedure. The incidence of stent fracture was 4.9% (18 of 364 lesions). Δangle in the target lesion was larger in the fracture group (28.3 ±11.5° vs 12.3 ±9.0°, P<0.0001). Independent predictors of stent fracture were Δangle and total stent length. The rates of binary restenosis and target lesion revascularization (TLR) were higher in the fracture group (33% vs 4.0%, P=0.0002 and 28% vs 3.5%, P=0.0007, respectively). There were no major adverse cardiac events (MACE) in the fracture group during a mean 24-month follow-up after follow-up CAG. Conclusions: Predictors of stent fracture were Δangle and total stent length. Although stent fracture was associated with ISR and TLR, it was not associated with MACE during long-term follow-up. (Circ J 2009; 73: 2036-2041)