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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 > or =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 approximately 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.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Kim HS,Kim YH,Lee SW,Park DW,Lee CW,Hong MK,Park SW,Ko JK,Park JH,Lee JH,Choi SW,Seong IW,Cho YH,Lee NH,Kim JH,Chun KJ,Park SJ,Long-DES-II study investigators.

doi

10.1016/j.ijcard.2008.01.005

subject

Has Abstract

pub_date

2009-04-17 00:00:00

pages

354-8

issue

3

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(08)00292-1

journal_volume

133

pub_type

杂志文章,随机对照试验

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