Longitudinal Stent Deformation in Undeployed Stents: A Case Series

Longitudinal stent deformation (LSD) is a recently reported problem with newer generation stents. The modification of stent materials and designs to make them more deliverable and conformable, as well as a focused approach in retaining their radial strength, has compromised longitudinal strength in currently available stents. Additionally, enhanced stent radiopacity, improved fluoroscopy, and heightened awareness have led to an increased incidence rate of the potentially under-recognized problem of LSD. Although originally described in deployed stents, LSD is being recognized in undeployed stents too. With available data to suggest an increased rate of adverse cardiac events like stent thrombosis and in-stent restenosis with LSD in deployed stents, an attempt to retrieve an undeployed deformed stent appears justified. We report 3 cases of LSD in undeployed stents and discuss its recognition. We also discuss the retrieval and visual inspection of retrieved stents and the simultaneous completion of coronary interventions via a double guide technique.

Direct coronary stent implantation does not reduce the incidence of in-stent restenosis or major adverse cardiac events Six month results of a randomized trial

European Heart Journal ◽

10.1016/s0195-668x(02)00701-7 ◽

2003 ◽

Vol 24 (5) ◽

pp. 421-429 ◽

Cited By ~ 28

Author(s):

A IJsselmuiden

Keyword(s):

Randomized Trial ◽

Stent Implantation ◽

Coronary Stent ◽

Cardiac Events ◽

Stent Restenosis ◽

Coronary Stent Implantation ◽

Adverse Cardiac Events ◽

The relation of serum monocytes to recurrent major adverse cardiac events in patients with a history of prior in-stent restenosis

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2007.03.127 ◽

2007 ◽

Vol 8 (2) ◽

pp. 131

Author(s):

M.A. Ferguson ◽

M. Needleman ◽

A. Bustamante ◽

E.S. Mitchell ◽

K. Love ◽

...

Keyword(s):

Cardiac Events ◽

Stent Restenosis ◽

Adverse Cardiac Events ◽

History Of ◽

A history of prior in-stent restenosis increases the risk of major adverse cardiac events in subsequent bare metal stenting of de novo coronary lesions

Cardiovascular Revascularization Medicine ◽

10.1016/j.carrev.2006.03.044 ◽

2006 ◽

Vol 7 (2) ◽

pp. 100

Author(s):

M.A. Ferguson

Keyword(s):

De Novo ◽

Bare Metal ◽

Cardiac Events ◽

Stent Restenosis ◽

Adverse Cardiac Events ◽

History Of ◽

Coronary Lesions ◽

Three-year follow-up after rotational atherectomy for the treatment of diffuse in-stent restenosis: Predictors of major adverse cardiac events

Catheterization and Cardiovascular Interventions ◽

10.1002/ccd.1177 ◽

2001 ◽

Vol 53 (3) ◽

pp. 334-340 ◽

Cited By ~ 4

Author(s):

Peter W. Radke ◽

Juergen vom Dahl ◽

Rainer Hoffmann ◽

Heinrich G. Klues ◽

Massud Hosseini ◽

...

Keyword(s):

Rotational Atherectomy ◽

Cardiac Events ◽

Stent Restenosis ◽

Adverse Cardiac Events ◽

Predictors of adverse cardiac events following beta brachytherapy for in-stent restenosis

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(02)80221-2 ◽

2002 ◽

Vol 39 ◽

pp. 51

Author(s):

Philip Urban ◽

Patrick Serruys ◽

Dietrich Baumgart ◽

Antonio Colombo ◽

Sigmund Silber ◽

...

Keyword(s):

Cardiac Events ◽

Stent Restenosis ◽

Adverse Cardiac Events ◽

Lumivascular Optical Coherence Tomography–Guided Atherectomy in Recurrent Femoropopliteal Occlusive Diseases Associated with In-Stent Restenosis: Case-Series Report

Vascular Health and Risk Management ◽

10.2147/vhrm.s260190 ◽

2020 ◽

Vol Volume 16 ◽

pp. 325-329

Author(s):

Yiu Che Chan ◽

Grace C Cheung ◽

Stephen W Cheng

Keyword(s):

Optical Coherence Tomography ◽

Case Series ◽

Optical Coherence ◽

Stent Restenosis ◽

Case Series Report ◽

Series Report ◽

In-stent restenosis and longitudinal stent deformation: a case report

BMC Cardiovascular Disorders ◽

10.1186/s12872-020-01335-1 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Daoyuan Si ◽

Yaliang Tong ◽

Bo Yu ◽

Yuquan He ◽

Guohui Liu

Keyword(s):

Case Report ◽

Stent Restenosis ◽

Stent Deformation ◽

Abstract 1926: The Incidence, Predictors, and Outcome of Delayed Stent Fracture After Successful Implantation of Sirolimus-Eluting Stents

Circulation ◽

10.1161/circ.116.suppl_16.ii_414-c ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Hisashi Umeda ◽

Tomoko Gochi ◽

Mitsunori Iwase ◽

Ryoji Ishiki ◽

Hideo Izawa ◽

...

Keyword(s):

Single Point ◽

Target Lesion ◽

Stent Fracture ◽

Consecutive Series ◽

Cardiac Events ◽

Stent Restenosis ◽

Late Lumen Loss ◽

Increased Risk ◽

Adverse Cardiac Events ◽

Stent Length

Background: Recently, stent fracture (SF) of sirolimus-eluting stents (SES) has been shown to be associated with an increased risk of restenosis after SES implantation. We sought to assess the incidence, predictors, and clinical outcome of SF after implantation of SES. Methods: A consecutive series of 430 lesions of 382 patients treated with SES followed by coronary angiography at 6 to 9 months were analyzed. SF was defined as complete transverse liner separation or single or multiple stent strut fracture. Results: At follow up, SF occurred in 33 of 430 lesions (7.7%), and 32 of 382 patients (8.4%). In 23 of 33 lesions (69.7%), SF was found in a single point, whereas SF occurred in 2 or more points per lesion in 10 lesions (30.3%). Minimal lumen diameter was significantly smaller in patients with SF (2.11±0.64 mm vs. 2.52±0.60 mm, P <0.001), presumably due to greater late lumen loss (0.36±0.57 mm vs. 0.08±0.50 mm, P =0.005). Consequently, in-stent restenosis in lesions with SF was observed more frequently than non-SF lesions (15.2% vs. 4.0%, P =0.004). At 450 days, however, the cumulative rate of major adverse cardiac events (death, myocardial infarction, or target lesion revascularization) was similar in patients with and without SF (9.1% vs. 7.1%, P =0.722). Multivariable predictors of SF were shown in Figure . Conclusions: The occurrence of SF 6 to 9 months after implantation of SES in consecutive “real-world” patients was relatively common, which did not lead to an increased risk of adverse cardiac events at 450 days. Total stent length, the reduction in the lesion angle by stenting, and lesions located on the right coronary artery were identified as predictors of SF after implantation of SES.