Fracture of a paclitaxol-eluting stent implanted for in-stent restenosis at the site of sirolimus-eluting stent fracture

Watanabe, Tôru; Tamura, Akira; Miyamoto, Kumie; Kadota, Jun‐ichi

doi:10.1016/j.ijcard.2008.11.036

Cited by 6 publications

(6 citation statements)

References 6 publications

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“…Furthermore, SES have a closed cell design in contrast to the open cell design of PES, which renders the former less deformable in response to dynamic loading imposed by cardiac movement. In one series, the incidence of SF was 1.7-2.4% following SES implantation [8,9]; however, SF has also been reported after bare-metal stent and paclitaxel-eluting stent implantation although it's extremely rare [7,10]. To our knowledge, this is the first report of SF after ZES implantation.…”

Section: Discussionmentioning

confidence: 76%

“…Many factors have been suggested as contributing factors for SF. Clinical factors, such as vessel tortousity in the proximal segment, are very important predisposing factors for SF [1] and there is a report of one such case in which second treatment with stent cross over with a paclitaxel-eluting stent (PES) developed recurrent SF [7]. Therefore, a highly angulated lesion in the right coronary artery is thought to be the common risk factor for SES and PES.…”

Section: Discussionmentioning

confidence: 99%

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Stent fracture and restenosis after zotarolimus-eluting stent implantation

Park¹,

Cho²,

Kim³

2011

International Journal of Cardiology

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Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Stent fracture and restenosis after zotarolimus-eluting stent implantation

Park¹,

Cho²,

Kim³

2011

International Journal of Cardiology

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“…The closed cell design of the SES is less deformable in response to dynamic loading imposed by the movement of coronary arteries and makes a weak point at which a stent fracture may develop. However, stent fracture has also been reported with paclitaxel-eluting stents or ZES, although it is extremely rare,10 and there have been no reported cases in the LAD in a hemodialyzed patient.…”

Section: Discussionmentioning

confidence: 99%

A Case of a Zotarolimus-Eluting Stent Fracture in the Left Anterior Descending Artery in a Patient Undergoing Hemodialysis

et al. 2011

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Although stent fracture after implantation of a drug-eluting stent (DES) is a rare complication, it has been suggested to be a cause of restenosis. To date, most DES fractures have been associated with sirolimus-eluting stents. We describe here a case of a zotarolimus-eluting stent fracture after 8 months of stent placement in a calcified left anterior descending artery lesion in a patient undergoing hemodialysis.

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“…The periodic links in these stents create a more longitudinally flexible stent but may compromise strength. The compromise for this flexibility is a stent that is more prone to compression and elongation—also stresses that may lead to fracture 14 …”

Section: Mechanism Of Stent Fracturesmentioning

confidence: 99%

Stent Fracture in the Coronary and Peripheral Arteries

Adlakha¹,

Sheikh²,

Wu³

et al. 2010

J Interven Cardiology

107

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Inherent risks of stenting include restenosis and thrombosis. Recently, stent fractures have been recognized as a complication that may result in thrombosis, perforation, restenosis, and migration of the stent resulting in morbidity and mortality. Stent fractures were originally seen in the superficial femoral arteries but have since then been reported in almost all vascular sites including the coronary, renal, carotid, iliac, and femoropopliteal arteries. Fractures are the result of the complex interplay between stent manufacturing, the stented segment, pulsatile and nonpulsatile biomechanical forces, and plaque morphology at a particular vascular site. The presentation of a patient with a fracture is highly variable, ranging from asymptomatic in nature, detected on routine screening without any sequelae, to sudden cardiac death related to a thrombosed coronary artery. Despite being recognized as an important complication, consensus on routine surveillance and diagnostic methods to detect fractures continues to be lacking. Fortunately, most cases are relatively benign and can be managed conservatively if detected. In the setting of recurrent symptoms, further intervention is usually sought. In review of the literature most cases are managed with placement of a stent over the fractured area, the stent-in-stent technique, but several other alternatives may be available. As the knowledge of the variables that make stents prone to fracture are identified, better technologies and techniques can be employed to minimize the risk of this complication. This article reviews the available literature on stent fractures and complications using data found on PubMed, MEDLINE, the Manufacturer and User Facility Device Experience (MAUDE) database, and the Cochrane databases.

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Fracture of a paclitaxol-eluting stent implanted for in-stent restenosis at the site of sirolimus-eluting stent fracture

Cited by 6 publications

References 6 publications

Stent fracture and restenosis after zotarolimus-eluting stent implantation

Stent fracture and restenosis after zotarolimus-eluting stent implantation

A Case of a Zotarolimus-Eluting Stent Fracture in the Left Anterior Descending Artery in a Patient Undergoing Hemodialysis

Stent Fracture in the Coronary and Peripheral Arteries

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