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KMID : 0191120110260010053
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Journal of Korean Medical Science
2011 Volume.26 No. 1 p.53 ~ p.58
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Clinical Characteristics of Coronary Drug-Eluting Stent Fracture: Insights from a Two-Center DES Registry
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Park Kyung-Woo
Park Jin-Joo
Chae In-Ho
Seo Jae-Bin
Yang Han-Mo
Lee Hae-Young
Kang Hyun-Jae
Cho Young-Seok
Yeon Tae-Jin
Chung Woo-Young
Koo Bon-Kwon
Choi Dong-Ju
Oh Byung-Hee
Park Young-Bae
Kim Hyo-Soo
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Abstract
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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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KEYWORD
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DES Fracture, Risk Factors, In-stent Restenosis, Target Vessel Revascularization, Clinical Outcome
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