BACKGROUND: Despite improved patency by development of the nitinol stent, stent fracture has emerged as a new problem in the percutaneous transluminal angioplasty of the superficial femoral artery (SFA). However, the factors influencing SFA stent fracture are not well understood. The aim of our study was to delineate the factors influencing and frequency of nitinol stent fracture in the SFA. METHODS: 89 consecutive patients with de-novo peripheral artery disease who underwent rescue stenting with a nitinol stent (SMART stent, Cordis) in the SFA were enrolled between May 2006 and January 2009. Follow-up angiography was performed 12.6짹 1.0 months later to detect stent fracture. Patients were divided to 2 groups based on the results of F/U angiography and/or fluroscpy: those with or without stent fracture. RESULTS: Stent fracture occurred in 15 patients (16.8%). Baseline patient characteristics were similar between those with and without stent fracture. The degree of limb ischemia and the ankle brachial index before the procedure were also similar between the groups. Lesion length >100 mm, the number of stents used, the lesion involving the distal SFA, TASC C and D, chronic total occlusion, and calcified lesion were more frequently observed in those with stent fracture than in those without fracture. Of these variables, Lesion length >100 mm, the number of stents used were the strongest independent determinant associated with stent fracture by discriminant analysis (p=0.01). CONCLUSION: Long lesion and multiple stenting adversely affects stent fracture in patients implanted with a nitinol stent in the SFA.