A multi-center retrospective analysis of causative anatomical and procedural factors and clinical outcomes of longitudinal coronary stent deformation

Abstract

Background and purpose: Longitudinal stent deformation (LSD) is a recently reported complication of percutaneous coronary intervention, but causative factors and associated clinical outcomes remain unknown. The purpose of this study is to have insight into procedural and anatomical factors that predispose to this complication and associated clinical outcomes. Methods and results: Twenty three cases of longitudinal coronary stent deformation were identified in 22 patients from March 2010 to August 2012 representing 0.56% of cases and affected 0.42% of stents deployed. The lesion in which LSD was identified were complex (lesion type B2/C 61.9%; B1 38.1%; A 0%) and most frequently occurred following attempts to pass secondary devices such as IVUS catheter (42.9%) and adjunctive balloon catheter (33.3%) through a previously deployed stent. Of the 23 deformed stents, the most common affected stent platform was the Element platform (56.5%) followed by the Driver platform (26.1%), and the Multi-link platform (17.3%). In 4 cases of complete stent apposition confirmed by previous IVUS study, LSD had been occurred in 12-month follow-up angiographic study. Proximal segment of left anterior descending artery (LAD) (26.1%) and left main ostium and trunk (21.7%) were the most prevalent site of LSD. Of the twenty three cases, re-stenting and/or re-ballooning were required in sixteen and major adverse cardiac event (MACE) did not occurred except one non-cardiac death. ![Figure][1] Conclusions: Longitudinal stent deformation can occur especially by secondary devices during PCI. Although seen in several different coronary segments and with several different stent platforms, in our study it was more commonly observed in proximal LAD and with the Element platform. [1]: pending:yes