Delayed stent fracture after successful sirolimus-eluting stent (cypher®) implantation

Jung Sun Kim, Young Won Yoon, Bum Kee Hong, Hyuk Moon Kwon, Jung Rae Cho, Dae Sik Choi, Young Guk Ko, Donghoon Choi, Yangsoo Jang, Byoung Keuk Kim, Sung Jin Oh, Dong Woon Jeon, Ju Young Yang

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background and Objectives: Sirolimus-eluting stent (SES) is very effective for preventing in-stent restenosis through the suppression of neointimal proliferation. Treatment failure cases related to stent fracture have recently been reported on, but any studies concerning the pattern or mechanism of SES fracture are very rare. Subjects and Methods: Between December 2003 to January 2005, 457 patients underwent follow-up coronary angiography after SES implantation at three referral center. We reviewed the angiographic and procedural data for eleven of theses patients [6 males (55%), mean age: 60 year-old age, range: 43-74 years] who were proven to have experience complete SES fracture. Results: The left anterior descending artery (LAD) and right coronary artery (RCA) stent fracture were 7 cases (63%) and 4 cases (37%), respectively. Myocardial bridge was shown in 6 cases with LAD fracture (86%). Overlapping stent implantation was performed in 5 cases (45%). The mean value of the maximal angulations at the fracture site before intervention was 50° (range; 39-70°) and the mean change between the maximal and minimal angulations was 13.2° (range; 2-28°). The mean stent diameter and length were 3.0 mm (range; 2.75-3.50 mm) and 40 mm (range; 23-52 mm). Stent inflation with high pressure was performed on 6 cases (54%) and it's frequency was higher in the RCA than the LAD (3 cases, 75%, mean inflation pressure: 13.1 mmHg). The mean follow-up duration was 7.2 month and only 2 cases were admitted due to the recurrent chest pain. The binary restenosis rate was 55% (6 cases) and the restenotic lesions were treated by balloon angioplasty in 2 cases and additional stenting was done in 2 cases. Conclusion: Our results demonstrated that SES fracture occurred in 7 cases with LAD lesion and in 4 cases with RCA lesion. Long stenting including overlapping implantation and more than 40° angulated long stent implantation may be the factors for SES fracture. Our results also showed high pressure stent inflation was performed more frequently at the RCA lesion, and myocardial bridge and kinking motion was detected more frequently at the LAD lesions.

Original languageEnglish
Pages (from-to)443-449
Number of pages7
JournalKorean Circulation Journal
Volume36
Issue number6
DOIs
Publication statusPublished - 2006 Jun

Fingerprint

Sirolimus
Stents
Arteries
Coronary Vessels
Economic Inflation
Pressure
Balloon Angioplasty
Coronary Angiography
Treatment Failure
Chest Pain
Referral and Consultation

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Kim, J. S., Yoon, Y. W., Hong, B. K., Kwon, H. M., Cho, J. R., Choi, D. S., ... Yang, J. Y. (2006). Delayed stent fracture after successful sirolimus-eluting stent (cypher®) implantation. Korean Circulation Journal, 36(6), 443-449. https://doi.org/10.4070/kcj.2006.36.6.443
Kim, Jung Sun ; Yoon, Young Won ; Hong, Bum Kee ; Kwon, Hyuk Moon ; Cho, Jung Rae ; Choi, Dae Sik ; Ko, Young Guk ; Choi, Donghoon ; Jang, Yangsoo ; Kim, Byoung Keuk ; Oh, Sung Jin ; Jeon, Dong Woon ; Yang, Ju Young. / Delayed stent fracture after successful sirolimus-eluting stent (cypher®) implantation. In: Korean Circulation Journal. 2006 ; Vol. 36, No. 6. pp. 443-449.
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title = "Delayed stent fracture after successful sirolimus-eluting stent (cypher{\circledR}) implantation",
abstract = "Background and Objectives: Sirolimus-eluting stent (SES) is very effective for preventing in-stent restenosis through the suppression of neointimal proliferation. Treatment failure cases related to stent fracture have recently been reported on, but any studies concerning the pattern or mechanism of SES fracture are very rare. Subjects and Methods: Between December 2003 to January 2005, 457 patients underwent follow-up coronary angiography after SES implantation at three referral center. We reviewed the angiographic and procedural data for eleven of theses patients [6 males (55{\%}), mean age: 60 year-old age, range: 43-74 years] who were proven to have experience complete SES fracture. Results: The left anterior descending artery (LAD) and right coronary artery (RCA) stent fracture were 7 cases (63{\%}) and 4 cases (37{\%}), respectively. Myocardial bridge was shown in 6 cases with LAD fracture (86{\%}). Overlapping stent implantation was performed in 5 cases (45{\%}). The mean value of the maximal angulations at the fracture site before intervention was 50° (range; 39-70°) and the mean change between the maximal and minimal angulations was 13.2° (range; 2-28°). The mean stent diameter and length were 3.0 mm (range; 2.75-3.50 mm) and 40 mm (range; 23-52 mm). Stent inflation with high pressure was performed on 6 cases (54{\%}) and it's frequency was higher in the RCA than the LAD (3 cases, 75{\%}, mean inflation pressure: 13.1 mmHg). The mean follow-up duration was 7.2 month and only 2 cases were admitted due to the recurrent chest pain. The binary restenosis rate was 55{\%} (6 cases) and the restenotic lesions were treated by balloon angioplasty in 2 cases and additional stenting was done in 2 cases. Conclusion: Our results demonstrated that SES fracture occurred in 7 cases with LAD lesion and in 4 cases with RCA lesion. Long stenting including overlapping implantation and more than 40° angulated long stent implantation may be the factors for SES fracture. Our results also showed high pressure stent inflation was performed more frequently at the RCA lesion, and myocardial bridge and kinking motion was detected more frequently at the LAD lesions.",
author = "Kim, {Jung Sun} and Yoon, {Young Won} and Hong, {Bum Kee} and Kwon, {Hyuk Moon} and Cho, {Jung Rae} and Choi, {Dae Sik} and Ko, {Young Guk} and Donghoon Choi and Yangsoo Jang and Kim, {Byoung Keuk} and Oh, {Sung Jin} and Jeon, {Dong Woon} and Yang, {Ju Young}",
year = "2006",
month = "6",
doi = "10.4070/kcj.2006.36.6.443",
language = "English",
volume = "36",
pages = "443--449",
journal = "Korean Circulation Journal",
issn = "1738-5520",
publisher = "Korean Society of Circulation",
number = "6",

}

Kim, JS, Yoon, YW, Hong, BK, Kwon, HM, Cho, JR, Choi, DS, Ko, YG, Choi, D, Jang, Y, Kim, BK, Oh, SJ, Jeon, DW & Yang, JY 2006, 'Delayed stent fracture after successful sirolimus-eluting stent (cypher®) implantation', Korean Circulation Journal, vol. 36, no. 6, pp. 443-449. https://doi.org/10.4070/kcj.2006.36.6.443

Delayed stent fracture after successful sirolimus-eluting stent (cypher®) implantation. / Kim, Jung Sun; Yoon, Young Won; Hong, Bum Kee; Kwon, Hyuk Moon; Cho, Jung Rae; Choi, Dae Sik; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo; Kim, Byoung Keuk; Oh, Sung Jin; Jeon, Dong Woon; Yang, Ju Young.

In: Korean Circulation Journal, Vol. 36, No. 6, 06.2006, p. 443-449.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Delayed stent fracture after successful sirolimus-eluting stent (cypher®) implantation

AU - Kim, Jung Sun

AU - Yoon, Young Won

AU - Hong, Bum Kee

AU - Kwon, Hyuk Moon

AU - Cho, Jung Rae

AU - Choi, Dae Sik

AU - Ko, Young Guk

AU - Choi, Donghoon

AU - Jang, Yangsoo

AU - Kim, Byoung Keuk

AU - Oh, Sung Jin

AU - Jeon, Dong Woon

AU - Yang, Ju Young

PY - 2006/6

Y1 - 2006/6

N2 - Background and Objectives: Sirolimus-eluting stent (SES) is very effective for preventing in-stent restenosis through the suppression of neointimal proliferation. Treatment failure cases related to stent fracture have recently been reported on, but any studies concerning the pattern or mechanism of SES fracture are very rare. Subjects and Methods: Between December 2003 to January 2005, 457 patients underwent follow-up coronary angiography after SES implantation at three referral center. We reviewed the angiographic and procedural data for eleven of theses patients [6 males (55%), mean age: 60 year-old age, range: 43-74 years] who were proven to have experience complete SES fracture. Results: The left anterior descending artery (LAD) and right coronary artery (RCA) stent fracture were 7 cases (63%) and 4 cases (37%), respectively. Myocardial bridge was shown in 6 cases with LAD fracture (86%). Overlapping stent implantation was performed in 5 cases (45%). The mean value of the maximal angulations at the fracture site before intervention was 50° (range; 39-70°) and the mean change between the maximal and minimal angulations was 13.2° (range; 2-28°). The mean stent diameter and length were 3.0 mm (range; 2.75-3.50 mm) and 40 mm (range; 23-52 mm). Stent inflation with high pressure was performed on 6 cases (54%) and it's frequency was higher in the RCA than the LAD (3 cases, 75%, mean inflation pressure: 13.1 mmHg). The mean follow-up duration was 7.2 month and only 2 cases were admitted due to the recurrent chest pain. The binary restenosis rate was 55% (6 cases) and the restenotic lesions were treated by balloon angioplasty in 2 cases and additional stenting was done in 2 cases. Conclusion: Our results demonstrated that SES fracture occurred in 7 cases with LAD lesion and in 4 cases with RCA lesion. Long stenting including overlapping implantation and more than 40° angulated long stent implantation may be the factors for SES fracture. Our results also showed high pressure stent inflation was performed more frequently at the RCA lesion, and myocardial bridge and kinking motion was detected more frequently at the LAD lesions.

AB - Background and Objectives: Sirolimus-eluting stent (SES) is very effective for preventing in-stent restenosis through the suppression of neointimal proliferation. Treatment failure cases related to stent fracture have recently been reported on, but any studies concerning the pattern or mechanism of SES fracture are very rare. Subjects and Methods: Between December 2003 to January 2005, 457 patients underwent follow-up coronary angiography after SES implantation at three referral center. We reviewed the angiographic and procedural data for eleven of theses patients [6 males (55%), mean age: 60 year-old age, range: 43-74 years] who were proven to have experience complete SES fracture. Results: The left anterior descending artery (LAD) and right coronary artery (RCA) stent fracture were 7 cases (63%) and 4 cases (37%), respectively. Myocardial bridge was shown in 6 cases with LAD fracture (86%). Overlapping stent implantation was performed in 5 cases (45%). The mean value of the maximal angulations at the fracture site before intervention was 50° (range; 39-70°) and the mean change between the maximal and minimal angulations was 13.2° (range; 2-28°). The mean stent diameter and length were 3.0 mm (range; 2.75-3.50 mm) and 40 mm (range; 23-52 mm). Stent inflation with high pressure was performed on 6 cases (54%) and it's frequency was higher in the RCA than the LAD (3 cases, 75%, mean inflation pressure: 13.1 mmHg). The mean follow-up duration was 7.2 month and only 2 cases were admitted due to the recurrent chest pain. The binary restenosis rate was 55% (6 cases) and the restenotic lesions were treated by balloon angioplasty in 2 cases and additional stenting was done in 2 cases. Conclusion: Our results demonstrated that SES fracture occurred in 7 cases with LAD lesion and in 4 cases with RCA lesion. Long stenting including overlapping implantation and more than 40° angulated long stent implantation may be the factors for SES fracture. Our results also showed high pressure stent inflation was performed more frequently at the RCA lesion, and myocardial bridge and kinking motion was detected more frequently at the LAD lesions.

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