Images in Clinical Medicine
Coronary-Stent Fracture
N Engl J Med 2002; 347:581August 22, 2002
- Article
Figure 1 A 57-year-old man presented with several hours of chest discomfort accompanied by ischemic changes on his electrocardiogram. He had undergone coronary-artery bypass grafting and subsequent percutaneous coronary intervention one year earlier, with deployment of a stent in the saphenous-vein graft to the first obtuse marginal artery. Cardiac angiography showed severe three-vessel disease of the native coronary arteries, a patent graft involving the left internal thoracic artery and the left anterior descending coronary artery, a previously identified occluded vein graft anastomosed to the right coronary artery, and a newly occluded vein graft anastomosed to the first obtuse marginal artery. The midportion of the stent was fractured. Multiple attempts to penetrate this occlusion with a wire were unsuccessful. The patient required an intraaortic balloon pump for the management of recurrent chest pain. Seven days later, he again underwent surgical revascularization.
Review of the cineangiogram obtained during the first catheterization showed that the stent was suboptimally deployed, resulting in narrowing of the midportion. Fracture of the midportion was most likely due to shear forces resulting from cardiac contractions.
Pertha S. Chowdhury, M.D.
Renato G. Ramos, M.D.
William Beaumont Hospital, Royal Oak, MI 48073-6769- Citing Articles (34)
Citing Articles
1
Adnan K. Chhatriwalla, Samuel Unzek, Samir R. Kapadia. (2010) Recurrent Stent Fracture in the Right Coronary Artery. Clinical Cardiology 33:12, E70-E72
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Harvey S. Hecht, Sotir Polena, Vladimir Jelnin, Marcelo Jimenez, Tandeep Bhatti, Manish Parikh, Georgia Panagopoulos, Gary Roubin. (2009) Stent Gap by 64-Detector Computed Tomographic Angiography. Journal of the American College of Cardiology 54:21, 1949-1959
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Takao Hanawa. (2009) Materials for metallic stents. Journal of Artificial Organs 12:2, 73-79
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Jeffrey J. Popma, Klaus Tiroch, Alexandra Almonacid, Sidney Cohen, David E. Kandzari, Martin B. Leon. (2009) A Qualitative and Quantitative Angiographic Analysis of Stent Fracture Late Following Sirolimus-Eluting Stent Implantation. The American Journal of Cardiology 103:7, 923-929
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Gilwoo Choi, Christopher P. Cheng, Nathan M. Wilson, Charles A. Taylor. (2009) Methods for Quantifying Three-Dimensional Deformation of Arteries due to Pulsatile and Nonpulsatile Forces: Implications for the Design of Stents and Stent Grafts. Annals of Biomedical Engineering 37:1, 14-33
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Aoi Kamura, Tomohiro Kawasaki, Nobuhiko Koga, Teruo Inoue, Koichi Node. (2008) Fracture of a sirolimus-eluting stent with migration. International Journal of Cardiology 130:2, e86-e88
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Luigi Pedon, Marco Zennaro, Diego Calzolari, Mario Zanchetta. (2008) Strut fracture: a further concern with drug-eluting stents. Journal of Cardiovascular Medicine 9:9, 949-952
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Gladius Lewis. (2008) Materials, fluid dynamics, and solid mechanics aspects of coronary artery stents: A state‐of‐the‐art review. Journal of Biomedical Materials Research Part B: Applied Biomaterials 86B:2, 569-590
CrossRef18
Fareed Shaikh, Rajesh Maddikunta, Mohamed Djelmami-Hani, Joaquin Solis, Suhail Allaqaband, Tanvir Bajwa. (2008) Stent fracture, an incidental finding or a significant marker of clinical in-stent restenosis?. Catheterization and Cardiovascular Interventions 71:5, 614-618
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Wook-Sung Chung, Chul-Soo Park, Ki-Bae Seung, Pum-Joon Kim, Jong-Min Lee, Bon-Kwon Koo, Yang-Soo Jang, Joo-Young Yang, Jung-Han Yoon, Doo-Il Kim, Young-Won Yoon, Jong-Seon Park, Yoon-Haeng Cho, Seung-Jung Park. (2008) The incidence and clinical impact of stent strut fractures developed after drug-eluting stent implantation. International Journal of Cardiology 125:3, 325-331
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Shusuke Yagi, Takehiko Kimura, Ikurou Hayashi, Takeshi Nishiuchi. (2008) Acute coronary syndrome due to hinge movement of a bare-metal stent. International Journal of Cardiology 123:3, e64-e66
CrossRef21
Hyun-Sook Lee, Seung-Ho Hur, Chang-Wook Nam, Yun-Kyeong Cho, Hyungseop Kim, Seong-Wook Han, Kwon-Bae Kim, Yoon-Nyun Kim. (2008) A Case of Stent Strut Fracture of a Paclitaxel-Eluting Stent at the Time of Stent Implantation in a Complex Coronary Lesion. Korean Circulation Journal 38:7, 387
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Daniel H. Steinberg, Lowell F. Satler, Augusto D. Pichard. (2007) Snare extraction of a fractured coronary stent in a saphenous vein graft. Catheterization and Cardiovascular Interventions 70:2, 241-243
CrossRef23
T.W. Koh, A. Mathur. (2007) Coronary stent fracture in a saphenous vein graft to right coronary artery — Successful treatment by the novel use of the Jomed coronary stent graft: Case report and review of the literature. International Journal of Cardiology 119:2, e43-e45
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Anderson Mehrle, Thomas Skelton, Alexandra Almonacid. (2007) Stent fracture: An unusual cause of late restenosis after sirolimus-eluting stent placement. Catheterization and Cardiovascular Interventions 69:7, 988-991
CrossRef25
Amgad N. Makaryus, Lance Lefkowitz, Alexander D. K. Lee. (2007) Coronary artery stent fracture. The International Journal of Cardiovascular Imaging 23:3, 305-309
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Xiaofeng Jin, Shuyang Zhang, Hongzhi Xie, Chonghui Wang, Zhongjie Fan, Yong Zeng, Zhujun Shen, Quan Fang. (2007) Strut fracture of DES: An increasing problem?. International Journal of Cardiology 118:2, e54-e56
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KJ Cavanaugh, VM Holt, JL Goode, E Anderson, SW Dean. (2006) FDA Recommendations for Nitinol Stent and Endovascular Graft Fatigue Characterization and Fracture Reporting. Journal of ASTM International 3:6, 100384
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