Delayed Stent Fracture after Successful Sirolimus-Eluting Stent(Cypher(R)) Implantation
Korean Circulation Journal
; : 443-449, 2006.
Artículo
en Coreano
| WPRIM (Pacífico Occidental)
| ID: wpr-32326
Biblioteca responsable:
WPRO
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 ANDMETHODS:
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 degrees (range; 39-70 degrees) and the mean change between the maximal and minimal angulations was 13.2 degrees (range; 2-28 degrees). 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 degrees 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.
Texto completo:
Disponible
Base de datos:
WPRIM (Pacífico Occidental)
Asunto principal:
Arterias
/
Derivación y Consulta
/
Dolor en el Pecho
/
Stents
/
Estudios de Seguimiento
/
Angiografía Coronaria
/
Insuficiencia del Tratamiento
/
Angioplastia de Balón
/
Vasos Coronarios
/
Sirolimus
Tipo de estudio:
Estudio observacional
/
Estudio pronóstico
Límite:
Humanos
/
Masculino
Idioma:
Coreano
Revista:
Korean Circulation Journal
Año:
2006
Tipo del documento:
Artículo