Difference in outcomes after repeat PCI for sirolimus-eluting stent restenosis lesions with or without stent fracture

Abstract

Background: Presence of stent fracture (SF) after sirolimus-eluting stent (SES) implantation has reported to be associated with an increased risk of in-stent restenosis and target lesion revascularization (TLR). Incidence of SF and the relevance to cardiovascular events are previously reported. But little is known about the outcomes after repeat DES implantation for SES restenosis lesion with SF. So this study compared the outcomes after repeat PCI for SES restenosis lesion with or without SF. Method: From April 2007 to August 2011, total 2020 lesions implanted SES during PCI at our hospital. Total 148 lesions, 7.3% had restenosis (defined as % diameter stenosis >50%) in follow up angiogram. One hundred seven lesions went to TLR, consisted of 75 lesions with repeat DES implantation and 32 lesions with balloon angioplasty alone. SF was defined as complete or partial separation of the stent as assessed by plain fluoroscopy and detected in 61 lesions of SES restenosis lesions. Thirty-three SES restenosis lesions with SF (SF group) and 42 SES restenosis lesions without SF (non SF group) were retrospectively evaluated re-restenosis rate during follow up after repeated implantation of DES. Result: Baseline characteristics were similar. One-year cumulative incidence of re-restenosis after repeat DES implantation for SF group and non SF group which calculated by Kaplan-Meier method were 68% and 36% (P=0.0332), respectively (Figure 1). ![Figure][1] Figure 1. One-year cumulative incidence of re-restenosis Conclusion: Restenosis lesions with SF had significantly high incidence of re-restenosis after repeat DES implantation. [1]: pending:yes