Incidence and predictors of drug-eluting stent fractures in long coronary disease

Hyun Sook Kim, Young Hak Kim, Seung Whan Lee, Duk Woo Park, Cheol Whan Lee, Myeongki Hong, Seong Wook Park, Jae Ki Ko, Jae Hyeong Park, Jae Hwan Lee, Si Wan Choi, In Whan Seong, Yoon Haeng Cho, Nae Hee Lee, June Hong Kim, Kook Jin Chun, Seung Jung Park

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Abstract

Background: Stent fractures after drug-eluting stent (DES) implantation have not been evaluated sufficiently in patients with long coronary artery disease. Methods: This study comprised of 415 patients, who were enrolled in the Long-DES-II study and had a complete serial angiography both before and after procedure and also at follow-up. The lesions were ≥ 25 mm in length and were randomly treated with sirolimus-eluting stents (SES, 210 lesions) or paclitaxel-eluting stent (205 lesions). Results: DES fracture was identified in 7 lesions (1.7%): 1 minor, 3 moderate, and 3 severe fractures. Most of the fractures occurred in patients who received SES (85.7%) and in the right coronary artery (RCA) lesions (71.4%). Lesions with fracture had a smaller minimal lumen diameter before procedure than lesions without fracture (0.38 ± 0.55 vs. 0.71 ± 0.46 mm, p = 0.043). However, acute gain (2.28 ± 0.39 vs. 1.44 ± 0.60 mm, p = 0.001) and late loss (0.81 ± 0.49 vs. 0.42 ± 0.50 mm, p = 0.033) in analysis segment were greater in lesions with fracture. By multivariate analysis, the independent predictor of fracture was the RCA lesion (Odds ratio, 7.81; 95% CI, 1.45 ∼ 42.04; p = 0.017). Although one patient had an intermediate angiographic narrowing at the fracture site, there was no adverse cardiac event related with fracture. Conclusions: The incidence of stent fracture in long DES implantation was not common and was associated with SES implantation or RCA lesions. Fortunately, the clinical prognosis of DES fracture was somewhat benign.

Original languageEnglish
Pages (from-to)354-358
Number of pages5
JournalInternational Journal of Cardiology
Volume133
Issue number3
DOIs
Publication statusPublished - 2009 Apr 17

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Drug-Eluting Stents
Coronary Disease
Stents
Incidence
Coronary Vessels
Sirolimus
Paclitaxel
Coronary Artery Disease
Angiography
Multivariate Analysis
Odds Ratio

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Hyun Sook ; Kim, Young Hak ; Lee, Seung Whan ; Park, Duk Woo ; Lee, Cheol Whan ; Hong, Myeongki ; Park, Seong Wook ; Ko, Jae Ki ; Park, Jae Hyeong ; Lee, Jae Hwan ; Choi, Si Wan ; Seong, In Whan ; Cho, Yoon Haeng ; Lee, Nae Hee ; Kim, June Hong ; Chun, Kook Jin ; Park, Seung Jung. / Incidence and predictors of drug-eluting stent fractures in long coronary disease. In: International Journal of Cardiology. 2009 ; Vol. 133, No. 3. pp. 354-358.
@article{6e7352a54b8e4e66938180aa16658164,
title = "Incidence and predictors of drug-eluting stent fractures in long coronary disease",
abstract = "Background: Stent fractures after drug-eluting stent (DES) implantation have not been evaluated sufficiently in patients with long coronary artery disease. Methods: This study comprised of 415 patients, who were enrolled in the Long-DES-II study and had a complete serial angiography both before and after procedure and also at follow-up. The lesions were ≥ 25 mm in length and were randomly treated with sirolimus-eluting stents (SES, 210 lesions) or paclitaxel-eluting stent (205 lesions). Results: DES fracture was identified in 7 lesions (1.7{\%}): 1 minor, 3 moderate, and 3 severe fractures. Most of the fractures occurred in patients who received SES (85.7{\%}) and in the right coronary artery (RCA) lesions (71.4{\%}). Lesions with fracture had a smaller minimal lumen diameter before procedure than lesions without fracture (0.38 ± 0.55 vs. 0.71 ± 0.46 mm, p = 0.043). However, acute gain (2.28 ± 0.39 vs. 1.44 ± 0.60 mm, p = 0.001) and late loss (0.81 ± 0.49 vs. 0.42 ± 0.50 mm, p = 0.033) in analysis segment were greater in lesions with fracture. By multivariate analysis, the independent predictor of fracture was the RCA lesion (Odds ratio, 7.81; 95{\%} CI, 1.45 ∼ 42.04; p = 0.017). Although one patient had an intermediate angiographic narrowing at the fracture site, there was no adverse cardiac event related with fracture. Conclusions: The incidence of stent fracture in long DES implantation was not common and was associated with SES implantation or RCA lesions. Fortunately, the clinical prognosis of DES fracture was somewhat benign.",
author = "Kim, {Hyun Sook} and Kim, {Young Hak} and Lee, {Seung Whan} and Park, {Duk Woo} and Lee, {Cheol Whan} and Myeongki Hong and Park, {Seong Wook} and Ko, {Jae Ki} and Park, {Jae Hyeong} and Lee, {Jae Hwan} and Choi, {Si Wan} and Seong, {In Whan} and Cho, {Yoon Haeng} and Lee, {Nae Hee} and Kim, {June Hong} and Chun, {Kook Jin} and Park, {Seung Jung}",
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language = "English",
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Kim, HS, Kim, YH, Lee, SW, Park, DW, Lee, CW, Hong, M, Park, SW, Ko, JK, Park, JH, Lee, JH, Choi, SW, Seong, IW, Cho, YH, Lee, NH, Kim, JH, Chun, KJ & Park, SJ 2009, 'Incidence and predictors of drug-eluting stent fractures in long coronary disease', International Journal of Cardiology, vol. 133, no. 3, pp. 354-358. https://doi.org/10.1016/j.ijcard.2008.01.005

Incidence and predictors of drug-eluting stent fractures in long coronary disease. / Kim, Hyun Sook; Kim, Young Hak; Lee, Seung Whan; Park, Duk Woo; Lee, Cheol Whan; Hong, Myeongki; Park, Seong Wook; Ko, Jae Ki; Park, Jae Hyeong; Lee, Jae Hwan; Choi, Si Wan; Seong, In Whan; Cho, Yoon Haeng; Lee, Nae Hee; Kim, June Hong; Chun, Kook Jin; Park, Seung Jung.

In: International Journal of Cardiology, Vol. 133, No. 3, 17.04.2009, p. 354-358.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Incidence and predictors of drug-eluting stent fractures in long coronary disease

AU - Kim, Hyun Sook

AU - Kim, Young Hak

AU - Lee, Seung Whan

AU - Park, Duk Woo

AU - Lee, Cheol Whan

AU - Hong, Myeongki

AU - Park, Seong Wook

AU - Ko, Jae Ki

AU - Park, Jae Hyeong

AU - Lee, Jae Hwan

AU - Choi, Si Wan

AU - Seong, In Whan

AU - Cho, Yoon Haeng

AU - Lee, Nae Hee

AU - Kim, June Hong

AU - Chun, Kook Jin

AU - Park, Seung Jung

PY - 2009/4/17

Y1 - 2009/4/17

N2 - Background: Stent fractures after drug-eluting stent (DES) implantation have not been evaluated sufficiently in patients with long coronary artery disease. Methods: This study comprised of 415 patients, who were enrolled in the Long-DES-II study and had a complete serial angiography both before and after procedure and also at follow-up. The lesions were ≥ 25 mm in length and were randomly treated with sirolimus-eluting stents (SES, 210 lesions) or paclitaxel-eluting stent (205 lesions). Results: DES fracture was identified in 7 lesions (1.7%): 1 minor, 3 moderate, and 3 severe fractures. Most of the fractures occurred in patients who received SES (85.7%) and in the right coronary artery (RCA) lesions (71.4%). Lesions with fracture had a smaller minimal lumen diameter before procedure than lesions without fracture (0.38 ± 0.55 vs. 0.71 ± 0.46 mm, p = 0.043). However, acute gain (2.28 ± 0.39 vs. 1.44 ± 0.60 mm, p = 0.001) and late loss (0.81 ± 0.49 vs. 0.42 ± 0.50 mm, p = 0.033) in analysis segment were greater in lesions with fracture. By multivariate analysis, the independent predictor of fracture was the RCA lesion (Odds ratio, 7.81; 95% CI, 1.45 ∼ 42.04; p = 0.017). Although one patient had an intermediate angiographic narrowing at the fracture site, there was no adverse cardiac event related with fracture. Conclusions: The incidence of stent fracture in long DES implantation was not common and was associated with SES implantation or RCA lesions. Fortunately, the clinical prognosis of DES fracture was somewhat benign.

AB - Background: Stent fractures after drug-eluting stent (DES) implantation have not been evaluated sufficiently in patients with long coronary artery disease. Methods: This study comprised of 415 patients, who were enrolled in the Long-DES-II study and had a complete serial angiography both before and after procedure and also at follow-up. The lesions were ≥ 25 mm in length and were randomly treated with sirolimus-eluting stents (SES, 210 lesions) or paclitaxel-eluting stent (205 lesions). Results: DES fracture was identified in 7 lesions (1.7%): 1 minor, 3 moderate, and 3 severe fractures. Most of the fractures occurred in patients who received SES (85.7%) and in the right coronary artery (RCA) lesions (71.4%). Lesions with fracture had a smaller minimal lumen diameter before procedure than lesions without fracture (0.38 ± 0.55 vs. 0.71 ± 0.46 mm, p = 0.043). However, acute gain (2.28 ± 0.39 vs. 1.44 ± 0.60 mm, p = 0.001) and late loss (0.81 ± 0.49 vs. 0.42 ± 0.50 mm, p = 0.033) in analysis segment were greater in lesions with fracture. By multivariate analysis, the independent predictor of fracture was the RCA lesion (Odds ratio, 7.81; 95% CI, 1.45 ∼ 42.04; p = 0.017). Although one patient had an intermediate angiographic narrowing at the fracture site, there was no adverse cardiac event related with fracture. Conclusions: The incidence of stent fracture in long DES implantation was not common and was associated with SES implantation or RCA lesions. Fortunately, the clinical prognosis of DES fracture was somewhat benign.

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U2 - 10.1016/j.ijcard.2008.01.005

DO - 10.1016/j.ijcard.2008.01.005

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JO - International Journal of Cardiology

JF - International Journal of Cardiology

SN - 0167-5273

IS - 3

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