Do drug elution components increase the risk of fracture of sirolimus-eluting stents?

Kawai, Tomoko; Umeda, Hisashi; Ota, Masaya; Hattori, Kousuke; Ishikawa, Makoto; Okumura, Masanori; Kan, Shino; Nakano, Tadashi; Naruse, Hiroyuki; Matsui, Shigeru; Ishii, Junichi

doi:10.1097/mca.0b013e32833aa6a1

Cited by 9 publications

(5 citation statements)

References 13 publications

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“…Notably, all but one SF in their analysis occurred with SES. Similar results were obtained by other studies with an incidence of

1.0% up to 18.6% [ 10 , 11 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. An analysis with new generation DES by Schochlow et al .…”

Section: Reviewsupporting

confidence: 91%

“…Notably, all but one SF in their analysis occurred with SES. Similar results were obtained by other studies with an incidence of <1.0% up to 18.6% [10,11,[14][15][16][17][18][19][20]]. An analysis with new generation DES by Schochlow et al [21] showed incidental detection of SF in 8% immediately after implantation and almost 60% in the setting of device failure.…”

Section: Incidence Of Stent Fracturessupporting

confidence: 78%

See 1 more Smart Citation

Coronary Stent Fracture Causing Myocardial Infarction: Case Report and Review of Literature

Gröger¹,

Rottbauer²,

Keßler³

2022

Rev. Cardiovasc. Med.

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Coronary stent fracture (SF) is a potential cause of stent failure increasing the risk for in-stent restenosis, stent thrombosis, target lesion revascularization and major adverse cardiac events. Overall incidence of SF ranges from <1.0% up to 18.6% and SF can be found in up to 60% of failed devices. Advanced imaging techniques have improved the detection of SF. However, defining the optimal therapeutic approach towards these complex lesions is challenging. This review summarizes the most important publications on the topic of SF and discusses current insights into pathophysiology, diagnostic tools, classification and therapeutic management. Furthermore, two illustrative cases of SF leading to myocardial infarction are presented, which demonstrate typical SF risk factors such as vessel angulation and hinge motion, stenting in the right coronary artery, use of long stents and multiple stent layers.

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“…Notably, all but one SF in their analysis occurred with SES. Similar results were obtained by other studies with an incidence of

1.0% up to 18.6% [ 10 , 11 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ]. An analysis with new generation DES by Schochlow et al .…”

Section: Reviewsupporting

confidence: 91%

Section: Incidence Of Stent Fracturessupporting

confidence: 78%

Coronary Stent Fracture Causing Myocardial Infarction: Case Report and Review of Literature

Gröger¹,

Rottbauer²,

Keßler³

2022

Rev. Cardiovasc. Med.

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“…Excluding the Kawai et al . report showing a nonsignificant difference with respect to stent fracture between the BMS and the DES (4.4% for the DES and 1.3% for the BMS, p value = 0,078) [13], the bulk of the evidences have shown statistically significant differences between the two major stent types [1-5]. It has been suggested that a greater neointimal proliferation in the BMS reduces the risk of fracture [14, 15] or /and less radio opacity renders the diagnosis of fracture more difficult [4].…”

Section: Predictors and Mechanismsmentioning

confidence: 99%

“…Although there are few investigations reporting equal frequencies of stent fracture in the different types of the DES [13], the majority of the available studies underscore a higher frequency of SF in SES [1-4]. Chakravarty et al .…”

Section: Predictors and Mechanismsmentioning

confidence: 99%

Coronary Stent Fracture: A Recently Appreciated Phenomenon with Clinical Relevance

Chinikar¹,

Sadeghipour

2014

CCR

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In the stent era, in addition to restenosis, there are many important consequences deserving more attention. Firstly described in peripheral vascular interventions, it took several years for stent fracture to be known as an appreciable complication of coronary intervention. Especially with the introduction of drug eluting stents and the use of coronary stents in more complex cases, its prevalence has raised and new data have been published concerning its mechanism, predictors, diagnosis, clinical course and treatments. This review will discuss the available literature about stent fracture.

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“…Further stent implantation should be avoided; DCB is considered an important option for such vessels. In addition, overlap with the previous stent is inevitable when treating SER using DES, and stent overlap is associated with a higher risk of adverse clinical events such as MI and TLR [ 34 , 35 ]. Likewise, multiple long stent implantations are associated with a high risk of periprocedural MI and stent thrombosis [ 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Drug-coated balloons for the treatment of stent edge restenosis

Nagasaka

Amanai

Ishibashi

et al. 2023

Coronary Artery Disease

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Background Drug-coated balloon (DCB) is a device for treating patients with in-stent restenosis; however, there are scant data on its efficacy for stent edge restenosis (SER). This study aimed to investigate the clinical outcomes of DCB use for treating SER compared with new-generation drug-eluting stent (DES) implantation. Method From December 2013 to January 2019, patients who underwent DES implantation or DCB for SER were enrolled. Clinical outcomes were analyzed, and propensity score with matching was conducted. The primary outcome was target-vessel revascularization (TVR). The secondary outcomes were the incidence of all-cause mortality, major adverse cardiovascular events (MACE), and target lesion revascularization (TLR). Result A total of 291 patients with SER were included: 160 were treated with DCB, and 131 with new-generation DES. DCB treatment for SER treatment was associated with a lower risk of TVR than DES [hazard ratio, 0.549; 95% confidence interval (CI), 0.339–0.891] at a median follow-up of 1080 days (interquartile range; 729–1080 days). Propensity score matching (PSM) was performed to adjust for baseline clinical and lesion characteristics. After PSM, no significant difference in the risk of TVR was observed (hazard ratio, 0.965; 95% CI, 0.523–1.781). Similarly, the risk for all-cause death (hazard ratio, 0.507; 95% CI, 0.093–2.770), MACE (hazard ratio: 0.812; 95% CI, 0.451–1.462), and TLR (hazard ratio: 0.962; 95% CI, 0.505–1.833) were comparable between the two groups. Conclusion DCB treatment efficacy for SER was similar to that of new-generation DES after PSM. DCB is a significant alternative to obtain comparable results with new-generation DES for the treatment of SER.

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Do drug elution components increase the risk of fracture of sirolimus-eluting stents?

Abstract: Stent implantation in right coronary artery lesions, tortuous lesions, and/or longer lesions covered with longer stents, and not SES versus BX-BMS use, may be associated with increased likelihood of SF.

Cited by 9 publications

References 13 publications

Coronary Stent Fracture Causing Myocardial Infarction: Case Report and Review of Literature

Coronary Stent Fracture Causing Myocardial Infarction: Case Report and Review of Literature

Coronary Stent Fracture: A Recently Appreciated Phenomenon with Clinical Relevance

Drug-coated balloons for the treatment of stent edge restenosis

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