Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations

Schochlow K, Weissner M, Blachutzik F, Boeder NF, Tröbs M, Lorenz L, Dijkstra J, Munzel T, Achenbach S, Nef H, Gori T (2021)

Publication Type: Journal article

Publication year: 2021

Journal

Journal of Clinical Medicine MDPI

Book Volume: 10

Journal Issue: 8

DOI: 10.3390/jcm10081765

Abstract

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.

Authors with CRIS profile

Monique Tröbs Department of Medicine 2 – Cardiology and Angiology Stephan Achenbach Lehrstuhl für Innere Medizin II

Involved external institutions

Universitätsmedizin der Johannes Gutenberg-Universität Mainz DE Germany (DE) Universitätsklinikum Gießen und Marburg (UKGM) DE Germany (DE) Leiden University NL Netherlands (NL)

How to cite

APA:

Schochlow, K., Weissner, M., Blachutzik, F., Boeder, N.F., Tröbs, M., Lorenz, L.,... Gori, T. (2021). Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations. Journal of Clinical Medicine, 10(8). https://dx.doi.org/10.3390/jcm10081765

MLA:

Schochlow, Katharina, et al. "Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations." Journal of Clinical Medicine 10.8 (2021).

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