Stent fracture and restenosis after zotarolimus-eluting stent implantation

Park, Jong Seon; Cho, Ihn-Ho; Kim, Young-Jo

doi:10.1016/j.ijcard.2009.01.030

Cited by 10 publications

(5 citation statements)

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“…They reported that stents with modular structure demonstrated better behavior than slotted tube ones in the tensile-compression fatigue test, and stents made of cobalt alloy had a longer endurance due to its better mechanical properties than stainless steel. In addition, clinical reporting of EN stent fracture is rare; to the best of our knowledge, it has been reported in only 3 cases [7][8][9]. These lines of available evidence strongly support the results of our study.…”

Section: Discussionsupporting

confidence: 89%

Incidence and clinical impact of fracture of drug-eluting stents widely used in current clinical practice: Comparison with initial platform of sirolimus-eluting stent

Park

Chang

Her

et al. 2012

Journal of Cardiology

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Section: Discussionsupporting

confidence: 89%

Incidence and clinical impact of fracture of drug-eluting stents widely used in current clinical practice: Comparison with initial platform of sirolimus-eluting stent

Park

Chang

Her

et al. 2012

Journal of Cardiology

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“…Hence SES is less deformable during dynamic cardiac movement, resulting in transmission of shear force possibly resulting in breakage of stent strut. Regarding second generation DES, there is limited data with only one case report on ZES fracture ( 15 ). The Endeavor® stent is a ZES based on the Driver® platform with its open cell design and cobalt alloy struts.…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Coronary Drug-Eluting Stent Fracture: Insights from a Two-Center DES Registry

Park

Chae

et al. 2011

J Korean Med Sci

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Stent fracture (SF) has been implicated as a risk factor for in-stent restenosis, but its incidence and clinical characteristics are not well established. Therefore we investigated the conditions associated with stent fracture and its clinical presentation and outcome. Between 2004 and 2007, consecutive cases of SF were collected from the Seoul National University Hospital. Clinical characteristics and outcome of patients with fractured stents were compared with a ten-fold cohort of age and gender matched controls (n = 236). A total of 4,845 patients received percutaneous coronary intervention and 3,315 patients (68.4%) underwent angiographic follow-up. Twenty-eight fractured stents were observed in 24 patients. The incidence of SF was 0.89% for sirolimus-eluting stents (SES) and 0.09% for paclitaxel-eluting stents. Chronic kidney disease, stent implantation in the right coronary artery (RCA), and SES use were independent predictors of drug-eluting stent fracture by multivariate analysis. SF was significantly associated with binary restenosis (11.4% vs 41.7%, P < 0.001) and increased risk of target lesion revascularization (8.1% vs 33.3%, P = 0.001). Patients with SF but without significant restenosis showed excellent outcome despite only medical treatment. In conclusion, SF is associated with increased rates of restenosis and repeat revascularization. Significant risk factors include chronic kidney disease, RCA intervention, and SES use.

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“…In general, there is greater curvature and range of motion in the right coronary artery (RCA) than in the left coronary artery, especially in the proximal-to-middle segment of the RCA, indicating more severe cardiac motion and angulation, a classic risk factor for metal fatigue ( 63 , 64 ). Additionally, overlapping stents, saphenous vein grafts, longer stent lengths, stainless stents and multiple stents are universally accepted to be related to CSF ( 13 – 15 , 19 , 54 , 65 – 68 ). Among these, Kuramitsu et al ( 35 ) revealed that hinge motion and tortuosity contributed the most to the incidence of CSF, suggesting that RCA lesions may be a more important risk factor for CSF.…”

Section: Discussionmentioning

confidence: 99%

Incidence of coronary drug-eluting stent fracture: A systematic review and meta-analysis

Chen

Liao

et al. 2022

Front. Cardiovasc. Med.

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BackgroundReported evidence of coronary stent fracture (CSF) has increased in recent years. The purpose of this study was to determine reliable estimates of the overall incidence of CSF.Methods and resultsThe MEDLINE, Embase and Cochrane databases were searched until March 18, 2022. Pooled estimates were acquired using random effects models. Meta-regression and subgroup analysis were used to explore sources of heterogeneity, and publication bias was evaluated by visual assessment of funnel plots and Egger’s test. Overall, 46 articles were included in this study. Estimates of CSF incidence were 5.5% [95% confidence interval (CI): 3.7–7.7%] among 39,953 patients based on 36 studies, 4.8% (95% CI: 3.1–6.8%) among 39,945 lesions based on 29 studies and 4.9% (95% CI: 2.5–9.4%) among 19,252 stents based on 8 studies. There has been an obvious increase in the incidence of CSF over the past two decades, and it seems that the duration of stent placement after stent implantation has no impact on incidence estimation.ConclusionThe incidence of CSF was 5.5% among patients, 4.8% for lesions and 4.9% for stents and increased over the past 20 years. The duration of stent placement after stent implantation was found to have no impact on the incidence of CSF, but drug-eluting stent (DES) types and right coronary artery (RCA) lesions influenced the pooled incidence.Systematic review registration[https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022311995], identifier [CRD42022311995].

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Stent fracture and restenosis after zotarolimus-eluting stent implantation

Cited by 10 publications

References 10 publications

Incidence and clinical impact of fracture of drug-eluting stents widely used in current clinical practice: Comparison with initial platform of sirolimus-eluting stent

Incidence and clinical impact of fracture of drug-eluting stents widely used in current clinical practice: Comparison with initial platform of sirolimus-eluting stent

Clinical Characteristics of Coronary Drug-Eluting Stent Fracture: Insights from a Two-Center DES Registry

Incidence of coronary drug-eluting stent fracture: A systematic review and meta-analysis

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