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Stent fracture and longitudinal compression detected on coronary CT angiography in the first- and new-generation drug-eluting stents

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Abstract

To evaluated prevalence and clinical implication of stent fracture and longitudinal compression in first- and new-generation drug-eluting stents (DES) using coronary computed tomography angiography (CCTA). The incidence of stent fracture and longitudinal compression were compared between first- and new-generation DES in 374 patients who underwent coronary stenting using DES and follow-up CCTA due to recurrent angina. 235 and 139 patients received 322 first- and 213 new-generation DES, respectively. The crude per-stent incidence of longitudinal compression (6.1 vs. 0.3 %, p < 0.001) was higher after new- than first-generation DES implantation using CCTA and the incidence of stent fracture (11.3 vs. 8.1 %, p = 0.23) was comparable. On follow-up coronary angiography for 347 stents, stent fracture (3.2 %) and longitudinal compression (0.9 %) were less detected than those on CCTA. Ostial stenting was a risk factor of longitudinal compression (p < 0.001). Stent fracture was associated with younger patients (p = 0.03), longer stent (p = 0.010), and excessively tortuous lesions (p = 0.001). The presence of stent fracture or longitudinal compression was not associated with poor clinical outcomes. The longitudinal compression more frequently occurred after new-generation DES implantation. The stent fracture was comparable between two DES. However, the occurrence of such mechanical deformities did not translate into a poor clinical outcome.

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Abbreviations

CAG:

Coronary angiography

CCTA:

Coronary computed tomography angiography

DES:

Drug-eluting stent

ISR:

In-stent restenosis

MACE:

Major adverse cardiac events

PCI:

Percutaneous coronary intervention

TVR:

Target vessel revascularization

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Funding source

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (NRF-2013R1A1A1058711) and a Grant of the Korean Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (HI12C0630).

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    Authors and Affiliations

    1. Department of Radiology and Research Institute of Radiology, Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul, 138-736, South Korea

      Mi Sun Chung, Dong Hyun Yang, Joon-Won Kang & Tae-Hwan Lim

    2. Department of Cardiology and Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

      Young-Hak Kim, Jae-Hyung Roh, Jung-Min Ahn, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Cheol Whan Lee, Seong-Wook Park & Seung-Jung Park

    3. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

      Jihyun Song

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    1. Mi Sun Chung
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    Correspondence to Dong Hyun Yang.

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    Dong Hyun Yang and Young-Hak Kim contributed equally to this article.

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    Chung, M.S., Yang, D.H., Kim, YH. et al. Stent fracture and longitudinal compression detected on coronary CT angiography in the first- and new-generation drug-eluting stents. Int J Cardiovasc Imaging 32, 637–646 (2016). https://doi.org/10.1007/s10554-015-0798-4

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