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Stent fracture occurs earlier than expect-serial fluoroscopic surveillance study
국민건강보험공단 일산병원
오성진, 김병극,전동운,양주영
Objectives Stent fracture(SF) after sirolimus-eluting stent(SES) is usually discovered with follow-up angiography.SF is not always associated with clinical recurrence so that we do not know the exact time when this adverse finding occurs. Method We demonstrated the usefullness of fluoroscopic surveillance for detecting SF in another study.We performed serial prospective fluoroscopic exam in high risk stent(33mm long stent) for SF at five follow-up sub-periods(at hospital discharge and 2weeks, 1month, 3months and 6months after intervention). All patients suspicious of SF were requested to undergo follow-up angiography and IVUS confirmation. Clinical, procedural and angiographic characteristics were analyzed and clinical and angiographic outcome were evaluated at&nb! sp;the time of 8month follow-up angiography. Result>From August 2005 to January 2007, 131stents in 102patients(male 84%, age 62±29) were included in this analysis and 121patients(92.4%) completed 6months fluoroscopic surveillance. Total eight SF were discovered(6.6%) and their profiles were presented at the table. All stents were those implanted at right coronary artery and showed high prevalence of stent overlapping(50%). All SF were discovered before 1month follow-up period except one (after 2months) and three of them were found before hospital discharge(6,3 and 4 days after intervention).Follow-up angiography was done in four patients and restenosis was not found in any of them. Conclusion SF were discovered at earlier stage than expected.
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Patient

Age

(yrs)

Sex

Target

vessel

Reference

Diameter

(mm)

Minimal

Luminal

diameter

(mm)

Lesion

length

(mm)

Stent

overlap

Time to SF

1

40

M

RCA

3.24

0.74

27.4

No

At discharge

2

56

M

RCA

3.43

0.93

27.0

No

At 2 wks

3

71

M

RCA

2.79

1.42

56.2

Yes

At 1 month

4

56

M

RCA

3.33

0.58

45.2

Yes

At discharge

5

64

M

RCA

2.87

0.84

30.2

No

At discharge

6

52

M

RCA

3.11

1.13

48.0

Yes

At 1 month

7

62

F

RCA

2.73

0.95

49.0

Yes

At 1 month

8

70

M

RCA

3.24

0.37

28.1

No

At 2 month



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