What is a stent fracture?

What is a stent fracture?

Introduction. Coronary stent fracture is defined as a discontinuation of any part of the stent structure seen on angiogram. Stent fracture (SF) was first described with bare-metal stents in 2002 [1.

How is stent restenosis treated?

Restenosis, a narrowing of blood vessels following angioplasty or stent placement is seen in up to 50% of patients. Cases are treated with various options, including drugs, mechanical devices such as stents, genetic treatment such as gene transfer or infusion of stem cells, and combinations of the above.

What causes restenosis in stents?

Restenosis is caused by an overgrowth of scar tissue. When a stent is first placed, healthy tissue from the lining of your cell walls grows inside of it. This is good because it keeps your blood from clotting as it flows through the stent.

What is stent restenosis?

In-stent restenosis (ISR) is the narrowing of a stented coronary artery lesion. The mean time from percutaneous coronary intervention (PCI) to ISR was 12 months with drug-eluting stents (DES) and 6 months with bare metal stents (BMS). ISR typically presents as recurrent angina.

What causes stent fracture?

Stent fracture may occur late as a result of mechanical fatigue or early in association with suboptimal deployment. When it occurs during deployment it is generally due to excessive tension on the stent with resultant stretching of the device.

How common is in stent restenosis?

Ellis says, “in-stent restenosis still occurs in approximately 3 to 10% of patients within six to nine months, and sometimes afterwards. We have learned that restenosis is a very complex process.” Some known causes include: Stents that are too small or misaligned in the blood vessel.

How can you prevent restenosis?

Restenosis Prevention

1. Drug-eluting stents.
2. Perivascular delivery which delivers the drug into the space around the artery.
3. Delivery catheters.
4. Antibody or peptide-linked drugs.
5. Gene-based therapies.
6. Cell-based therapies.
7. Nanoparticle-based drug delivery.

How can stent restenosis be prevented?

Prevention of in-stent restenosis These strategies are 1) mechanical strategies, 2) systemic drugs, 3) intracoronary radiation, 4) drug-coated and eluting stents, and 5) prospective therapies.

Is stent restenosis common?

When does in stent restenosis occur?

What does restenosis mean? Restenosis occurs when the treated vessel becomes blocked again. It usually occurs within 6 months after the initial procedure. Compared with balloon angioplasty alone, where the chance of restenosis is 40%, stents reduce the chance of restenosis to 25%.

How often does in stent restenosis occur?

What is the prevalence of restenosis of drug eluting stents?

Email Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC. Despite on-going evolution and iteration of drug-eluting stent (DES) technology, the prevalence of in-stent restenosis (ISR) remains relatively unchanged, encompassing ≈10% of percutaneous coronary interventions.

Which is better drug eluting stents or bare metal stents?

Restenosis after angioplasty and stent implantation has been historically considered the most significant problem in coronary interventional treatment ( 1 ). Drug-eluting stents (DES) have dramatically reduced the rates of restenosis and target lesion revascularization (TLR) compared with bare-metal stents (BMS) ( 2 ).

Is there a problem with DES in stents?

However, the rapid implementation of DES in standard practice and expansion of the indications for percutaneous coronary intervention to high-risk patients and complex lesions also introduced a new problem: DES in-stent restenosis (ISR), which occurs in 3% to 20% of patients, depending on patient and lesion characteristics and DES type.

Which is better EES or paclitaxel eluting stent?

Recent large randomized studies have shown that the next-generation EES is superior to the first-generation paclitaxel-eluting stent (PES) in terms of reducing repeat revascularization, MI, and stent thrombosis ( 16, 17 ). Although some cases of ISR are clinically silent, the majority lead to recurrent symptoms.