Abstract 14458: Incidence and Clinical Impact of Stent Fracture After the Nobori Biolimus-Eluting Stent Implantation
Background: Stent fracture (SF) after drug-eluting stent implantation has recently became an important concern because of its potential association with in-stent restenosis and stent thrombosis. However, the incidence and clinical impact of SF after biolimus-eluting stent (BES) remains unclear.
Methods: A total of 1031 patients with 1407 lesions undergoing BES (NoboriTM, Terumo, Tokyo, Japan) implantation and follow-up angiography 6 to 9 months after index procedure were analyzed. SF was defined as complete or partial separation of the stent, as assessed by plain fluoroscopy, intravascular ultrasound, or optical coherence tomography during follow-up. We assessed the rate of SF and major adverse cardiac events, defined as cardiac death, myocardial infarction, stent thrombosis, and clinically driven target lesion revascularization within 9 months.
Results: SF was observed in 58 of 1407 lesions (4.1%) and 57 of 1031 patients (5.5%). Lesions with hinge motion (odd ratio [OR], 6.15; 95% confidence interval [CI], 3.40-11.46; P<0.001), tortuosity (OR, 3.12; 95% CI, 1.46-7.31; P=0.003), or overlapping stents (OR, 2.66; 95% CI, 1.23-5.81; P=0.013) were independent predictors of SF. Major adverse cardiac events within 9 months were significantly higher in the SF group than in the non-SF group (28.1% vs. 4.6%, P<0.001). The rate of target lesion revascularization was significantly higher in the SF group than in the non-SF group (28.0% vs. 4.1%, P<0.001), whereas the rate of myocardial infarction and stent thrombosis were not different between the 2 groups (1.8% vs. 1.0%, P=0.61; 1.8% vs. 0.9%, P=0.53, respectively).
Conclusions: SF after BES occurs in 4.1% of lesions and is associated with higher rate of major adverse cardiac events, driven by higher rate of target lesion revascularization.
- © 2013 by American Heart Association, Inc.