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ȣ - 530722 166 |
Intravascular ultrasound features of drug-eluting stent fractures |
계명대학교 동산병원¹ , 인제대학교 부산백병원² |
조윤경¹, 허승호¹,길윤정¹,박형섭¹,윤혁준¹,김윤년¹,김권배¹,김웅² ,양태현² ,김두일² ,김동수² |
Background: Intravascular ultrasound (IVUS) may be more likely to identify characteristics of stent fracture compared with angiography. Methods: Eleven patients with stent fracture detected by IVUS were enrolled. Quantitative IVUS analysis was performed using computerized planimetry. Results: Mean duration between the index procedure and follow-up IVUS was 953 ± 546 days. All cases of stent fracture occurred in Cypher stents. Seven stent fractures were located in right coronary artery (63.6%) and 4 in left anterior descending artery (36.4%). Three stent fractures (27.3%) were associated with instent restenosis and 2 stent fractures (18.2%) with target lesion revascularization. IVUS analysis showed that 2 stent factures were complete (18.2%) and 9 were partial (81.8%); 1 (9.1%) was adjacent to stent metal overlap; and 3 (27.3%) occurred in a coronary aneurysm despite the absence of aneurysm at post-procedure. In addition, 5 (45.5%) were adjacent to calcium (arc of calcification: 118 ± 83°). Vessel area and stent area at the site of stent fracture were significantly larger than those of stented segment. Conclusion: IVUS is helpful to identify stent facture and to understand possible mechanism of stent facture such as calcification and aneurysmal change.
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Stent length, mm |
50.64 ± 20.20 |
Fracture length, mm |
2.05 ± 2.01 |
Proximal reference segment |
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Vessel CSA, mm3/mm |
18.72 ± 4.70 |
Lumen CSA, mm3/mm |
9.71 ± 2.87 |
Distal reference segment |
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Vessel CSA, mm3/mm |
12.81 ± 6.26 |
Lumen CSA, mm3/mm |
7.83 ± 4.25 |
Stented segment |
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Vessel CSA, mm3/mm |
17.14 ± 4.94 |
Stent CSA, mm3/mm |
7.77 ± 2.42 |
Lumen CSA, mm3/mm |
7.66 ± 2.42 |
Site of stent fracture |
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Vessel CSA, mm3/mm |
19.86 ± 5.34* |
Stent CSA, mm3/mm |
9.28 ± 3.18* |
Lumen CSA, mm3/mm |
9.03 ± 3.07 |
* : comparison between stented segment and site of stent fracture |
CSA : cross-sectional area |
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