Incidence and predictors of drug-eluting stent fractures in long coronary disease

Hyun Sook Kim, Young Hak Kim, Seung Whan Lee, Duk Woo Park, Cheol Whan Lee, Myeong Ki Hong, Seong Wook Park, Jae Ki Ko, Jae Hyeong Park, Jae Hwan Lee, Si Wan Choi, In Whan Seong, Yoon Haeng Cho, Nae Hee Lee, June Hong Kim, Kook Jin Chun, Seung Jung Park

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33 Citations (Scopus)


Background: Stent fractures after drug-eluting stent (DES) implantation have not been evaluated sufficiently in patients with long coronary artery disease. Methods: This study comprised of 415 patients, who were enrolled in the Long-DES-II study and had a complete serial angiography both before and after procedure and also at follow-up. The lesions were ≥ 25 mm in length and were randomly treated with sirolimus-eluting stents (SES, 210 lesions) or paclitaxel-eluting stent (205 lesions). Results: DES fracture was identified in 7 lesions (1.7%): 1 minor, 3 moderate, and 3 severe fractures. Most of the fractures occurred in patients who received SES (85.7%) and in the right coronary artery (RCA) lesions (71.4%). Lesions with fracture had a smaller minimal lumen diameter before procedure than lesions without fracture (0.38 ± 0.55 vs. 0.71 ± 0.46 mm, p = 0.043). However, acute gain (2.28 ± 0.39 vs. 1.44 ± 0.60 mm, p = 0.001) and late loss (0.81 ± 0.49 vs. 0.42 ± 0.50 mm, p = 0.033) in analysis segment were greater in lesions with fracture. By multivariate analysis, the independent predictor of fracture was the RCA lesion (Odds ratio, 7.81; 95% CI, 1.45 ∼ 42.04; p = 0.017). Although one patient had an intermediate angiographic narrowing at the fracture site, there was no adverse cardiac event related with fracture. Conclusions: The incidence of stent fracture in long DES implantation was not common and was associated with SES implantation or RCA lesions. Fortunately, the clinical prognosis of DES fracture was somewhat benign.

Original languageEnglish
Pages (from-to)354-358
Number of pages5
JournalInternational Journal of Cardiology
Issue number3
Publication statusPublished - 2009 Apr 17

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine


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