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Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations

Introduction. The frequency, characteristics and clinical implications of Strut fractures (SFs) remain incompletely understood. Methods and results. A total of 185 (160 patients) newer-generation drug-eluting stents (DES) were imaged. SFs were found in 21 DES (11.4%) and were classified in four patt...

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Autores principales: Schochlow, Katharina, Weissner, Melissa, Blachutzik, Florian, Boeder, Niklas F., Tröbs, Monique, Lorenz, Liv, Dijkstra, Jouke, Münzel, Thomas, Achenbach, Stephan, Nef, Holger, Gori, Tommaso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072680/
https://www.ncbi.nlm.nih.gov/pubmed/33921606
http://dx.doi.org/10.3390/jcm10081765
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author Schochlow, Katharina
Weissner, Melissa
Blachutzik, Florian
Boeder, Niklas F.
Tröbs, Monique
Lorenz, Liv
Dijkstra, Jouke
Münzel, Thomas
Achenbach, Stephan
Nef, Holger
Gori, Tommaso
author_facet Schochlow, Katharina
Weissner, Melissa
Blachutzik, Florian
Boeder, Niklas F.
Tröbs, Monique
Lorenz, Liv
Dijkstra, Jouke
Münzel, Thomas
Achenbach, Stephan
Nef, Holger
Gori, Tommaso
author_sort Schochlow, Katharina
collection PubMed
description Introduction. The frequency, characteristics and clinical implications of Strut fractures (SFs) remain incompletely understood. Methods and results. A total of 185 (160 patients) newer-generation drug-eluting stents (DES) were imaged. SFs were found in 21 DES (11.4%) and were classified in four patterns: one single stacked strut (41%); two or more stacked struts (23%); deformation without gap (27%); transection (9%). In multivariable analysis, calcific and bifurcation lesions were associated with SF in DES (OR: 3.5 [1.1–11] and 4.0 [2.2–7.2], p < 0.05). Device eccentricity and asymmetry as well as optical coherence tomography (OCT) features of impaired strut healing were also associated with SF. The prevalence of fractures was similar in a set of 289 bioresorbable scaffolds (BRS). In a separate series of 20 device thromboses and 36 device restenoses, the prevalence of SF was higher (61.2% of DES and 66.7% of BRS, p < 0.001 for both), with a higher frequency of complex SF patterns (p < 0.0001). In logistic regression analysis, fractures were a correlate of device complications (p < 0.0001, OR = 24.9 [5.6–111] for DES and OR = 6.0 [1.8–20] for BRS). Discussion. The prevalence of OCT-diagnosed SF was unexpectedly high in the setting of elective controls and it increased by about three-fold in the setting of device failure. Fractures were associated with increased lesion complexity and device asymmetry/eccentricity and were more frequent in the setting of device failure such as restenosis and thrombosis.
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spelling pubmed-80726802021-04-27 Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations Schochlow, Katharina Weissner, Melissa Blachutzik, Florian Boeder, Niklas F. Tröbs, Monique Lorenz, Liv Dijkstra, Jouke Münzel, Thomas Achenbach, Stephan Nef, Holger Gori, Tommaso J Clin Med Article Introduction. The frequency, characteristics and clinical implications of Strut fractures (SFs) remain incompletely understood. Methods and results. A total of 185 (160 patients) newer-generation drug-eluting stents (DES) were imaged. SFs were found in 21 DES (11.4%) and were classified in four patterns: one single stacked strut (41%); two or more stacked struts (23%); deformation without gap (27%); transection (9%). In multivariable analysis, calcific and bifurcation lesions were associated with SF in DES (OR: 3.5 [1.1–11] and 4.0 [2.2–7.2], p < 0.05). Device eccentricity and asymmetry as well as optical coherence tomography (OCT) features of impaired strut healing were also associated with SF. The prevalence of fractures was similar in a set of 289 bioresorbable scaffolds (BRS). In a separate series of 20 device thromboses and 36 device restenoses, the prevalence of SF was higher (61.2% of DES and 66.7% of BRS, p < 0.001 for both), with a higher frequency of complex SF patterns (p < 0.0001). In logistic regression analysis, fractures were a correlate of device complications (p < 0.0001, OR = 24.9 [5.6–111] for DES and OR = 6.0 [1.8–20] for BRS). Discussion. The prevalence of OCT-diagnosed SF was unexpectedly high in the setting of elective controls and it increased by about three-fold in the setting of device failure. Fractures were associated with increased lesion complexity and device asymmetry/eccentricity and were more frequent in the setting of device failure such as restenosis and thrombosis. MDPI 2021-04-19 /pmc/articles/PMC8072680/ /pubmed/33921606 http://dx.doi.org/10.3390/jcm10081765 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Schochlow, Katharina
Weissner, Melissa
Blachutzik, Florian
Boeder, Niklas F.
Tröbs, Monique
Lorenz, Liv
Dijkstra, Jouke
Münzel, Thomas
Achenbach, Stephan
Nef, Holger
Gori, Tommaso
Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations
title Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations
title_full Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations
title_fullStr Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations
title_full_unstemmed Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations
title_short Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations
title_sort coronary stent strut fractures: classification, prevalence and clinical associations
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8072680/
https://www.ncbi.nlm.nih.gov/pubmed/33921606
http://dx.doi.org/10.3390/jcm10081765
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