Late stent fracture – A potential role of left ventricular dilatation

Abstract

Different anatomical coronary settings have been described as predisposing factors to stent fracture. Consequently, the remodeling of the left ventricle, together with the rise in diastolic pressure, may have affected the shear stress of LAD stents by increasing mechanical forces produced in the diastolic phase on the epicardial vessel. In addition, left ventricular enlargement could have increased the elongation forces on the stent frames by altering the curvature of the stent. All predisposing factors of stent fracture, including coronary and left ventricular issues, need to be considered before stent implantation to avoid stent fracture and clinical sequelae.

Adverse Cardiac Remodelling after Acute Myocardial Infarction: Old and New Biomarkers

“…Additionally, neoatherosclerosis and uncovered stent struts were reported as the primary cause of late thrombosis in 35% cases and 10% cases, respectively [24]. Although coronary stent fracture is an underrecognized event, it has been reported frequently in the drug-eluting stent era [25]. However, investigators have shown that technical problems with first-generation eluting stent implantations in STEMI patients were associated with higher inhospital mortality and posthospital target vessel failure or cardiac death [24].…”