Incidence and Clinical Impact of Stent Fracture After the Nobori Biolimus‐Eluting Stent Implantation

Abstract

BackgroundStent fracture (SF) after drug‐eluting stent implantation has become an important concern. The aim of this study was to assess the incidence, predictors, and clinical impact of SF after biolimus‐eluting stent.Methods and ResultsA total of 1026 patients with 1407 lesions undergoing the Nobori biolimus‐eluting stent implantation and follow‐up angiography within 9 months after index procedure were analyzed. SF was defined as complete or partial separation of the stent, as assessed by using plain fluoroscopy, intravascular ultrasound, or optical coherence tomography during the follow‐up. We assessed the rate of SF and the cumulative incidence of clinically driven target lesion revascularization and definite stent thrombosis within 9 months. SF was observed in 58 (4.1%) of 1407 lesions and 57 (5.5%) of 1026 patients. Lesions with hinge motion (OR 8.90, 95% CI 3.84 to 20.6, P<0.001), tortuosity (OR 4.16, 95% CI 1.75 to 9.88, P=0.001), and overlapping stents (OR 2.41, 95% CI 0.95 to 6.10, P=0.06) were predictors of SF. Cumulative incidence of clinically driven target lesion revascularization within 9 months was numerically higher in the SF group than that in the non‐SF group (12.0% versus 1.0%). Cumulative incidence of definite stent thrombosis within 9 months tended to be higher in the SF group than that in the non‐SF group (1.7% versus 0.5%).ConclusionsSF after biolimus‐eluting stent occurs in 4.1% of lesions and appears to be associated with clinically driven target lesion revascularization.

The long term results of vertebral artery ostium stenting in a single center

“…These findings are consistent with previous observations regarding vessel tortuosity for adverse events associated with both carotid artery and coronary angioplasty and stenting 19 33. The areas of curves and twists were all at hinge movement points.…”

“…The occurrence of stent fractures is recognized as a potential complication of stent deployment. Its incidence varies markedly in published coronary studies, ranging from <1% to >16% 19 29–31. There have also been case reports on stent fracture after VAO stenting 11–15.…”

Optical coherence tomography to evaluate coronary stent implantation and complications

“…It is more frequently reported with first-generation SES [53,55], perhaps reflective of its closed cell design [47], thicker struts (154 μm), and thinner interconnecting links. It has also been shown in more recent devices such as zotarolimus-eluting and third-generation DES using biodegradable polymers, such as the Biolimus-eluting stent (Terumo Corporation, Tokyo, Japan) [56,57]. BMS-related stent fracture, however, has only been reported sporadically and mostly in vein grafts [58,59].…”

Unexpected retraction of an implanted coronary stent

“…The utilization of coronary stent has broken new ground in percutaneous coronary intervention (PCI); however, it has also brought new complications to cardiology, like frequent stent restenosis and stent thrombosis and, rarely, stent fracture and stent dislodgement (1)(2)(3)(4)(5). These complications can lead to myocardial infarction, emergency operation, peripheral and cerebral embolism, and even death (2)(3)(4)(5)(6)(7)(8).…”

“…Atrial fibrillation (AF) is the most common chronic cardiac arrhythmia (1,2). Major mortality and morbidity are associated with stroke and systemic embolism in patients with AF (3).…”