Top

The International Journal of Cardiovascular Imaging

Published in:

01-04-2016 | Original Paper

Stent fracture and longitudinal compression detected on coronary CT angiography in the first- and new-generation drug-eluting stents

Authors: Mi Sun Chung, Dong Hyun Yang, Young-Hak Kim, Jae-Hyung Roh, Jihyun Song, Joon-Won Kang, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Cheol Whan Lee, Seong-Wook Park, Seung-Jung Park, Tae-Hwan Lim

Published in: The International Journal of Cardiovascular Imaging | Issue 4/2016

Abstract

To evaluated prevalence and clinical implication of stent fracture and longitudinal compression in first- and new-generation drug-eluting stents (DES) using coronary computed tomography angiography (CCTA). The incidence of stent fracture and longitudinal compression were compared between first- and new-generation DES in 374 patients who underwent coronary stenting using DES and follow-up CCTA due to recurrent angina. 235 and 139 patients received 322 first- and 213 new-generation DES, respectively. The crude per-stent incidence of longitudinal compression (6.1 vs. 0.3 %, p < 0.001) was higher after new- than first-generation DES implantation using CCTA and the incidence of stent fracture (11.3 vs. 8.1 %, p = 0.23) was comparable. On follow-up coronary angiography for 347 stents, stent fracture (3.2 %) and longitudinal compression (0.9 %) were less detected than those on CCTA. Ostial stenting was a risk factor of longitudinal compression (p < 0.001). Stent fracture was associated with younger patients (p = 0.03), longer stent (p = 0.010), and excessively tortuous lesions (p = 0.001). The presence of stent fracture or longitudinal compression was not associated with poor clinical outcomes. The longitudinal compression more frequently occurred after new-generation DES implantation. The stent fracture was comparable between two DES. However, the occurrence of such mechanical deformities did not translate into a poor clinical outcome.

Bilen E, Saatci Yasar A, Bilge M, Karakas F, Kirbas O, Ipek G (2010) Acute coronary syndrome due to complete bare metal stent fracture in the right coronary artery. Int J Cardiol 139(3):e44–46. doi:10.1016/j.ijcard.2008.11.010 CrossRefPubMed

Yagi S, Kimura T, Hayashi I, Nishiuchi T (2008) Acute coronary syndrome due to hinge movement of a bare-metal stent. Int J Cardiol 123(3):e64–66. doi:10.1016/j.ijcard.2007.01.002 CrossRefPubMed

Lee MS, Jurewitz D, Aragon J, Forrester J, Makkar RR, Kar S (2007) Stent fracture associated with drug-eluting stents: clinical characteristics and implications. Catheter Cardiovasc Interv 69(3):387–394. doi:10.1002/ccd.20942 CrossRefPubMed

Sianos G, Hofma S, Ligthart JM, Saia F, Hoye A, Lemos PA, Serruys PW (2004) Stent fracture and restenosis in the drug-eluting stent era. Catheter Cardiovasc Interv 61(1):111–116. doi:10.1002/ccd.10709 CrossRefPubMed

Lim HB, Hur G, Kim SY, Kim YH, Kwon SU, Lee WR, Cha SJ (2008) Coronary stent fracture: detection with 64-section multidetector CT angiography in patients and in vitro. Radiology 249(3):810–819. doi:10.1148/radiol.2493088035 CrossRefPubMed

Park MW, Chang K, Her SH, Lee JM, Choi YS, Kim DB, Kim PJ, Cho JS, Choi MS, Baek JY, Park CS, Yoon SG, Chung WS, Seung KB (2012) Incidence and clinical impact of fracture of drug-eluting stents widely used in current clinical practice: comparison with initial platform of sirolimus-eluting stent. J Cardiol 60(3):215–221. doi:10.1016/j.jjcc.2012.07.011 CrossRefPubMed

Serikawa T, Kawasaki T, Koga H, Orita Y, Ikeda S, Goto Y, Shintani Y, Kajiwara M, Tanaka H, Fukuyama T, Koga N (2011) Late catch-up phenomenon associated with stent fracture after sirolimus-eluting stent implantation: incidence and outcome. J Interv Cardiol 24(2):165–171. doi:10.1111/j.1540-8183.2010.00614.x CrossRefPubMed

Lee SW, Tam FC, Chan KK (2011) Very late stent thrombosis due to DES fracture: description of a case and review of potential causes. Catheter Cardiovasc Interv 78(7):1101–1105. doi:10.1002/ccd.23101 CrossRefPubMed

Tsujita K, Maehara A, Mintz GS, Poon M, Maiolino G, Sugaya T, Igarashi K, Ochiai M (2009) Cross-sectional and longitudinal positive remodeling after subintimal drug-eluting stent implantation: multiple late coronary aneurysms, stent fractures, and a newly formed stent gap between previously overlapped stents. JACC Cardiovasc Interv 2(2):156–158. doi:10.1016/j.jcin.2008.11.008 CrossRefPubMed

10.

Ormiston JA, Webber B, Webster MW (2011) Stent longitudinal integrity bench insights into a clinical problem. JACC Cardiovasc Interv 4(12):1310–1317. doi:10.1016/j.jcin.2011.11.002 CrossRefPubMed

11.

Williams PD, Mamas MA, Morgan KP, El-Omar M, Clarke B, Bainbridge A, Fath-Ordoubadi F, Fraser DG (2012) Longitudinal stent deformation: a retrospective analysis of frequency and mechanisms. EuroIntervention 8(2):267–274. doi:10.4244/EIJV8I2A41 CrossRefPubMed

12.

Leibundgut G, Gick M, Toma A, Valina C, Loffelhardt N, Buttner HJ, Neumann FJ (2013) Longitudinal compression of the platinum-chromium everolimus-eluting stent during coronary implantation: predisposing mechanical properties, incidence, and predictors in a large patient cohort. Catheter Cardiovasc Interv 81(5):E206–214. doi:10.1002/ccd.24472 CrossRefPubMed

13.

von Birgelen C, Sen H, Lam MK, Danse PW, Jessurun GA, Hautvast RW, van Houwelingen GK, Schramm AR, Gin RM, Louwerenburg JW, de Man FH, Stoel MG, Lowik MM, Linssen GC, Said SA, Nienhuis MB, Verhorst PM, Basalus MW, Doggen CJ, Tandjung K (2014) Third-generation zotarolimus-eluting and everolimus-eluting stents in all-comer patients requiring a percutaneous coronary intervention (DUTCH PEERS): a randomised, single-blind, multicentre, non-inferiority trial. Lancet 383(9915):413–423. doi:10.1016/s0140-6736(13)62037-1 CrossRef

14.

Hecht HS, Polena S, Jelnin V, Jimenez M, Bhatti T, Parikh M, Panagopoulos G, Roubin G (2009) Stent gap by 64-detector computed tomographic angiography relationship to in-stent restenosis, fracture, and overlap failure. J Am Coll Cardiol 54(21):1949–1959. doi:10.1016/j.jacc.2009.06.045 CrossRefPubMed

15.

Romaguera R, Roura G, Gomez-Lara J, Ferreiro JL, Gracida M, Teruel L, de Albert M, Ariza A, Gomez-Hospital JA, Cequier A (2014) Longitudinal deformation of drug-eluting stents: evaluation by multislice computed tomography. J Invasive Cardiol 26(4):161–166PubMed

16.

Tsai IC, Choi BW, Chan C, Jinzaki M, Kitagawa K, Yong HS, Yu W (2010) ASCI 2010 appropriateness criteria for cardiac computed tomography: SCI 2010 appropriateness criteria for cardiac computed tomography: a report of the Asian Society of Cardiovascular Imaging Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging Guideline Working Group. Int J Cardiovasc Imaging 26(Suppl 1):1–15. doi:10.1007/s10554-009-9577-4 CrossRefPubMed

17.

Bartorelli AL, Andreini D, Pontone G, Trabattoni D, Ferrari C, Mushtaq S, Ormiston JA (2012) Stent longitudinal distortion: strut separation (pseudo-fracture) and strut compression (“concertina” effect). EuroIntervention 8(2):290–291. doi:10.4244/EIJV8I2A44 CrossRefPubMed

18.

Ormiston JA, Webber B, Ubod B, White J, Webster MWI (2014) Stent longitudinal strength assessed using point compression: insights from a second-generation, clinically related bench test. Circ Cardiovasc Interv 7(1):62–69. doi:10.1161/circinterventions.113.000621 CrossRefPubMed

19.

Abbara S, Arbab-Zadeh A, Callister TQ, Desai MY, Mamuya W, Thomson L, Weigold WG (2009) SCCT guidelines for performance of coronary computed tomographic angiography: a report of the Society of Cardiovascular Computed Tomography Guidelines Committee. J Cardiovasc Comput Tomogr 3(3):190–204. doi:10.1016/j.jcct.2009.03.004 CrossRefPubMed

20.

Zhang X, Yang L, Ju H, Zhang F, Wu J, He B, Chen Y (2012) Prevalence and prognosis of coronary stent gap detected by multi-detector CT: a follow-up study. Eur Radiol 22(9):1896–1903. doi:10.1007/s00330-012-2458-6 CrossRefPubMed

21.

Hanratty CG, Walsh SJ (2011) Longitudinal compression: a “new” complication with modern coronary stent platforms-time to think beyond deliverability? EuroIntervention 7(7):872–877. doi:10.4244/EIJV7I7A135 CrossRefPubMed

22.

Foerst J, Foin N, Hettleman B (2012) Longitudinal stent compression demonstrated by angiographic “wedding band” and 3-dimensional optical coherence tomography. JACC Cardiovasc Interv 5(12):e39–40. doi:10.1016/j.jcin.2012.08.015 CrossRefPubMed

23.

Arnous S, Shakhshir N, Wiper A, Ordoubadi FF, Williams P, Clarke B, Mahadavan V, El-Omar M, Mamas M, Fraser D (2014) Incidence and mechanisms of longitudinal stent deformation associated with Biomatrix, Resolute, Element, and Xience stents: angiographic and case-by-case review of 1800 PCIs. Catheter Cardiovasc Interv. doi:10.1002/ccd.25790

24.

Mamas MA, Williams PD (2012) Longitudinal stent deformation: insights on mechanisms, treatments and outcomes from the food and drug administration manufacturer and user facility device experience database. EuroIntervention 8(2):196–204. doi:10.4244/EIJV8I2A33 CrossRefPubMed

25.

Leibundgut G, Loffelhardt N, Toma A, Neumann FJ, Gick M (2012) Optical coherence tomography of longitudinal stent compression. EuroIntervention 8(8):989. doi:10.4244/EIJV8I8A149 CrossRefPubMed

26.

Park KW, Kang SH, Kang HJ, Koo BK, Park BE, Cha KS, Rhew JY, Jeon HK, Shin ES, Oh JH, Jeong MH, Kim S, Hwang KK, Yoon JH, Lee SY, Park TH, Moon KW, Kwon HM, Hur SH, Ryu JK, Lee BR, Park YW, Chae IH, Kim HS (2014) A randomized comparison of platinum chromium-based everolimus-eluting stents versus cobalt chromium-based Zotarolimus-Eluting stents in all-comers receiving percutaneous coronary intervention: HOST-ASSURE (harmonizing optimal strategy for treatment of coronary artery stenosis-safety & effectiveness of drug-eluting stents & anti-platelet regimen), a randomized, controlled, noninferiority trial. J Am Coll Cardiol 63(25 Pt A):2805–2816. doi:10.1016/j.jacc.2014.04.013 CrossRefPubMed

27.

Inaba S, Weisz G, Kobayashi N, Saito S, Dohi T, Dong L, Wang L, Moran JA, Rabbani LE, Parikh MA, Leon MB, Moses JW, Mintz GS, Maehara A (2014) Prevalence and anatomical features of acute longitudinal stent deformation: an intravascular ultrasound study. Catheter Cardiovasc Interv 84(3):388–396. doi:10.1002/ccd.25411 CrossRefPubMed

28.

Prabhu S, Schikorr T, Mahmoud T, Jacobs J, Potgieter A, Simonton C (2012) Engineering assessment of the longitudinal compression behaviour of contemporary coronary stents. EuroIntervention 8(2):275–281. doi:10.4244/EIJV8I2A42 CrossRefPubMed

Title: Stent fracture and longitudinal compression detected on coronary CT angiography in the first- and new-generation drug-eluting stents
Authors: Mi Sun Chung
Dong Hyun Yang
Young-Hak Kim
Jae-Hyung Roh
Jihyun Song
Joon-Won Kang
Jung-Min Ahn
Duk-Woo Park
Soo-Jin Kang
Seung-Whan Lee
Cheol Whan Lee
Seong-Wook Park
Seung-Jung Park
Tae-Hwan Lim
Publication date: 01-04-2016
Publisher: Springer Netherlands
Published in: The International Journal of Cardiovascular Imaging / Issue 4/2016
Print ISSN: 1569-5794
Electronic ISSN: 1875-8312
DOI: https://doi.org/10.1007/s10554-015-0798-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Stent fracture and longitudinal compression detected on coronary CT angiography in the first- and new-generation drug-eluting stents

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2016

NASCI AHA young investigator finalists 2015

Cardiac remodelling identified by cardiovascular magnetic resonance in patients with hepatitis C infection and liver disease

Are changes in the extent of left ventricular dyssynchrony as assessed by speckle tracking associated with response to cardiac resynchronization therapy?

Assessment of coronary in-stent restenosis: value of subtraction coronary computed tomography angiography

The relationship between blood pressure variability, obesity and left atrial phasic function in hypertensive population

Influence of beta-blocker therapy on aortic blood flow in patients with bicuspid aortic valve