The presence of long and heavily calcified lesions predisposes for fracture in patients undergoing stenting of the first part of the subclavian artery.
J Vasc Surg
; 70(4): 1146-1154.e1, 2019 10.
Article
em En
| MEDLINE
| ID: mdl-30926275
ABSTRACT
OBJECTIVE:
To determine the prevalence and risk factors of subclavian artery stent fractures and to investigate their impact on in-stent restenosis development.METHODS:
One hundred eight patients (65 females; median age, 58.3 years [interquartile range, 53.4-65.5 years]) with steno-occlusive disease of the first part of the subclavian artery who underwent stenting (N = 108 stents; balloon-expandable, 83.3%; self-expandable, 16.7%) between 2005 and 2015 and returned for a fluoroscopic examination of the implanted stents in 2017 were included in our study. Fractures were type I (single strut fracture), type II (multiple strut fractures without deformation), type III (multiple strut fractures with deformation), type IV (multiple strut fractures with acquired transection but without gap), or type V (multiple strut fractures with acquired transection with gap in the stent body). Stent patency was monitored by duplex ultrasound imaging. The Mann-Whitney U and Fisher's exact tests; Kaplan-Meier, receiver operating characteristic, and logistic regression analyses; as well as a log-rank test were used as statistical methods.RESULTS:
The median follow-up was 73.8 months (interquartile range, 35.6-104.2 months). Thirty-eight fractures (35.2%) were detected; fractures were type I in 13, type II in 12, type III in 6, type IV in 4, and type V in 3 cases. Multivariable logistic regression analysis revealed the presence of long (≥20 mm) lesions (odds ratio, 3.3; 95% confidence interval, 1.3-8.4; P = .012) and heavy calcification (odds ratio, 4.7; 95% confidence interval, 1.7-12.7; P = .002) to be significant independent predictors of stent fracture. The primary patency rates were significantly worse (P = .035) in patients with stent fracture compared with those without stent fracture.CONCLUSIONS:
Stent fractures frequently occur. Patients with long and/or heavily calcified lesions require closer follow-up.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Síndrome do Roubo Subclávio
/
Falha de Prótese
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Stents
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Angioplastia com Balão
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Calcificação Vascular
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article