High frequency of brachiocephalic trunk stent fractures does not impair clinical outcome

Abstract

IA stent fractures are common but seem to have no effect on symptoms and in-stent restenosis rates.

The incidence and risk factors of stent fracture in patients treated for proximal common carotid artery stenosis

“…11 In contrast with these findings, we did not observe any association between either ISR or postprocedural symptoms and SF in patients who underwent innominate artery stenting. 10 Neither did this study reveal impact of SF on ISR and reintervention rates. The reason behind the controversial findings in the published studies regarding the importance of SF on adverse clinical outcomes might be the differences in the type of stent used, the follow-up duration, and the SF classification systems.…”

“…We have previously reported a 34% SF rate in patients treated for innominate artery stenoses/occlusions. 10 The incidence of fracture was found to be 35% in patients who had stenting of the prevertebral subclavian artery either with balloon-expandable or self-expandable models. 11 The 39% SF rate revealed by the current study is in keeping with these experiences.…”

“…21,22 The alteration of regional wall rigidity and creation of significant focal mechanical irritation on particular struts of the stents are thought to be the mechanisms through which calcification is associated with SF. 10 Several studies examining the coronary and lower limb arteries have revealed an increase in adverse clinical events in tandem with SF. [21][22][23] However, not much is known about the relationship of SF and ISR after stent placement in vessels of the aortic arch.…”

“…8 Except for one study including eight patients with proximal CCA stenting by Usman et al, 9 no detailed information is available about the incidence of CCA SFs. We hypothesized that CCA SFs, similar to innominate and subclavian artery SFs, 10,11 are common owing to the close proximity of the beating heart and the shear forces from the curvature of the aortic arch. 9 The primary objective of this study was to examine the prevalence of SFs after endovascular treatment of the proximal third of the CCA and to determine the correlation between SFs and ISR as well as reintervention rates.…”

Lower Rate of Restenosis and Reinterventions With Covered vs Bare Metal Stents Following Innominate Artery Stenting

“…Last, the presence or absence of stent fracture was not detailed, though this seems to be of particular frequency with BMS in the innominate artery. 33 This is a limit in the direct comparison of both BMS and BECS, but inversely, it is an additional argument for the use of covered rather than bare stents because stent fracture is not a clinical issue with BECS.…”