Incidence and Long-Term Clinical Impact of Late-Acquired Stent Fracture After Sirolimus-Eluting Stent Implantation in Narrowed Coronary Arteries

Abstract The incidence and long-term clinical impact of stent fracture (SF) occurred beyond 1-year after sirolimus-eluting stent (SES) implantation remains unclear. From April 2004 and March 2008, 985 consecutive patients with 1307 lesions were treated only with SES. Of these, 868 patients (88.1%) with 1140 lesions underwent follow-up angiography within 1-year after the index procedure, and 646 patients (65.6%) with 872 lesions underwent it both within and beyond 1-year after the index procedure. According to the diagnosed timing of SF, we divided the patients into the 2 groups: early SF (1-year after the index procedure). Early and late-acquired SFs were observed in 64 of 868 patients (7.4%) and 66 of 1140 lesions (5.8%); 12 of 646 patients (1.9%) and 12 of 872 lesions (1.4%), respectively. Cumulative 10-year incidence of clinically-driven target lesion revascularization (CDTLR) and definite stent thrombosis (ST) were numerically higher in the early and late-acquired SF groups than in the non-SF group (41.6% vs. 45.5% vs. 19.0%; 8.0% vs. 8.3% vs. 2.0%, respectively). In conclusion, late-acquired SF after SES implantation occurred in 1.4% of lesions, which was lower than that of early SF. However, both early- and late-acquired SFs appeared to be associated with CDTLR and ST during the long-term follow-up.