Late asymptomatic sirolimus-eluting stent fracture in a female with systemic lupus erythematosus

Flat panel digital detector cinefluoroscopy late following SES or BMS implantation for detection of coronary stent fracture in asymptomatic patients

“…It may be that less severe SF types without major alterations of the stent architecture are more difficult to identify with this technique. Similarly, OCT has also been used to detect SF, and it is considered that due to its high resolution gives unique insights into the in-vivo appearance of this complication [27,28]. However, we were able to identify the region of fracture with certainty in only 42.8% of cases, all of the most severe form (1 Type-4 and 2 Type-3), and with significant restenosis.…”

Incidence of coronary drug-eluting stent fracture: A systematic review and meta-analysis

“…IVUS and OCT have been used as more sensitive methods for the detection of stent fracture due to their high resolution ( 16 , 58 , 59 ). In addition, multislice computed tomography (CT) ( 42 ) and CT angiography ( 27 , 60 , 61 ) have been identified as ideal imaging modalities for CSF than CAG.…”

A novel method of treating stent fractures

“…Optical coherence tomography (OCT), with its excellent resolution of 10-15 μm, has been described as confirming the SF diagnosis, 4,26,27 or even detecting cases missed by angiography. 28 Excessive intimal hyper-plasia, altered stent geometry and complete fracture of the stents with lack of circumferential struts at the fracture site are depicted dramatically on OCT.…”

“…Routine follow up after DES implantation (with high-resolution cine-angiography or IVUS) has been suggested in order to avoid SF underreporting and to assess its clinical consequences. 40 Additionally, various reports 4,[26][27][28] advocate the use of OCT for SF detection and possibly better risk stratification and optimal treatment of these patients (including the appropriate duration of dual antiplatelet therapy), as the presence of uncovered and/or misaligned struts at the SF level could lead to more aggressive clinical decisions.…”