Coronary Stent Fracture: A Recently Appreciated Phenomenon with Clinical Relevance

Chinikar, Madjid; Sadeghipour, Parham

doi:10.2174/1573403x10666140404105923

Cited by 21 publications

(18 citation statements)

References 42 publications

(154 reference statements)

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“…A coronary stent fracture is a discontinuation of any part of the stent structure seen on angiogram [ 3 ]. Depending on the study and type of stent, the incidences of SF lie between 0.5% and 19% [ 4 – 7 ]. In a pathological study, the incidence rose as high as 29% [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

“…These factors are all related to abnormal forces placed on the stent, creating metal fatigue and eventual fracture. Vessel tortuosity (especially in the right coronary artery), vessel calcification, ostial stent location, hinge motion, overlapping stents, increased stent length, smaller stent diameter, coronary aneurysm, and balloon overdilation are some of the known risk factors for SF [ 3 , 4 , 6 , 7 , 11 ]. The design of the Synergy due to its thin-strut and platinum chromium platform is said to incur flexibility and strength to prevent SF [ 3 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Our patient had experienced intractable chest pain believed to be caused by the in-stent restenosis precipitated by the stent fracture. Clinically concerning complications of coronary stent fractures are acute coronary syndromes (ACS), in-stent restenosis (ISR), stent thrombosis (ST), and the possible need for target vessel revascularization (TVR) [ 3 , 4 , 11 – 13 ]. These manifestations are related to the disruption of the stent structure and the malapposition of the stent struts to the intimal surface of the vessel.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

An Interesting Case and Literature Review of a Coronary Stent Fracture in a Current Generation Platinum Chromium Everolimus-Eluting Stent

Aung

Latt

Kyaw

et al. 2018

Case Reports in Cardiology

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Coronary interventions are the mainstay of treatment for stenotic coronary vascular lesions. New stent designs are constantly being evaluated to improve stent performances and clinical outcomes. Coronary stent fracture is uncommon; however, it is associated with potential major consequences including acute coronary syndrome and the need for repeated target vessel revascularization due to in-stent restenosis or stent thrombosis. We report a case of a 66-year-old man with an extensive cardiac disease history, who presented with intractable angina and was found to have a fracture of a current generation, platinum chromium everolimus-eluting stent (Synergy, Boston Scientific Inc.).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An Interesting Case and Literature Review of a Coronary Stent Fracture in a Current Generation Platinum Chromium Everolimus-Eluting Stent

Aung

Latt

Kyaw

et al. 2018

Case Reports in Cardiology

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“…In addition, duodenal peristalsis and tumor compression can promote stent fracture occurrence. Operation-related factors, such as selecting stent size, passing the stent across the ampulla ( P = 0.09), and pre- or postdilation ( P = 0.10), may also contribute to stent fracture development [ 17 ]. Concerning stent patency time, no significant difference between the fracture and nonfracture groups was obtained ( P = 0.52).…”

Section: Discussionmentioning

confidence: 99%

Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction

Zhou

Baojie

Wang

et al. 2018

Gastroenterology Research and Practice

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Background Palliative therapies for malignant biliary obstruction (MBO) include choledochojejunostomy and self-expanding metallic stent (SEMS) insertion. Fractures following SEMS insertion in MBO treatment are scarce. Objective To assess the clinical features of biliary stent fractures and evaluate associated factors. Methods One hundred fifty-six consecutive patients who underwent biliary SEMS placement for MBO treatment at Beijing Chaoyang Hospital affiliated to Capital Medical University, in 2010–2015, were evaluated retrospectively. Demographics, clinical features, stent parameters and patency times, and survival times were collected. Across the ampulla of Vater, balloon dilatation, number of stents, stent patency time, and survival time were compared between the stent and nonstent fracture groups. Results There were 168 biliary metallic stents inserted in 156 patients, including 144 and 12 patients with one and 2-3 stents, respectively. Pre- and/or postballoon dilation was performed in 107 patients. Stents across and above the duodenal papilla were used in 105 and 51 patients, respectively. Six cases (3.8%) with stent occlusion had stent fractures. Single- and multiple-stent fracture rates were 4/144 (2.8%) and 2/12 (16.7%), respectively. Fracture times after stent deployment were 126.8 ± 79.0 (median, 115.5) days. Stent patency times in the stent and nonstent fracture groups were 151.8 ± 67.8 (median, 160.5) days and 159.3 ± 73.6 (median, 165.5) days, respectively. Overall survival times in the stent and nonstent fracture groups were 399.7 ± 147.6 (median, 364.0) days and 283.7 ± 126.1 (median, 289.0) days, respectively. Conclusion Stent fractures following MBO treatment constitute a relatively rare long-term complication. Though there were no factors found to be significantly associated with SEMSs fracture, a trend could be observed towards more fractures in multistent, transpapillary, and balloon dilation groups.

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“…Vascular stenting is widely used clinically with excellent clinical outcomes for the patient. Among various forms of cardiovascular stent surgeries, the overlapping stent technique has been frequently used to avoid incomplete stenting and secondary implantation [1][2][3]. In a study by Yamada and Koizumi [4], 102 consecutive sirolimus-eluting stents (SES) were implanted in 83 lesions, with 43 SES as multiple overlapping stents.…”

Section: Introductionmentioning

confidence: 99%

Finite Element Analysis of the Implantation Process of Overlapping Stents

Jiang

Yang

Sohrabi

et al. 2017

Journal of Medical Devices

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Overlapping stents are widely used in vascular stent surgeries. However, the rate of stent fractures (SF) and in-stent restenosis (ISR) after using overlapping stents is higher than that of single stent implantations. Published studies investigating the nature of overlapping stents rely primarily on medical images, which can only reveal the effect of the surgery without providing insights into how stent overlap influences the implantation process. In this paper, a finite element analysis of the overlapping stent implantation process was performed to study the interaction between overlapping stents. Four different cases, based on three typical stent overlap modes and two classical balloons, were investigated. The results showed that overlapping contact patterns among struts were edge-to-edge, edge-to-surface, and noncontact. These were mainly induced by the nonuniform deformation of the stent in the radial direction and stent tubular structures. Meanwhile, the results also revealed that the contact pressure was concentrated in the edge of overlapping struts. During the stent overlap process, the contact pattern was primarily edge-to-edge contact at the beginning and edge-to-surface contact as the contact pressure increased. The interactions between overlapping stents suggest that the failure of overlapping stents frequently occurs along stent edges, which agrees with the previous experimental research regarding the safety of overlapping stents. This paper also provides a fundamental understanding of the mechanical properties of overlapping stents.

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Coronary Stent Fracture: A Recently Appreciated Phenomenon with Clinical Relevance

Cited by 21 publications

References 42 publications

An Interesting Case and Literature Review of a Coronary Stent Fracture in a Current Generation Platinum Chromium Everolimus-Eluting Stent

An Interesting Case and Literature Review of a Coronary Stent Fracture in a Current Generation Platinum Chromium Everolimus-Eluting Stent

Self-Expanding Metallic Stent Fracture in the Treatment of Malignant Biliary Obstruction

Finite Element Analysis of the Implantation Process of Overlapping Stents

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