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The presence of long and heavily calcified lesions predisposes for fracture in patients undergoing stenting of the first part of the subclavian artery.
Hüttl, András Béla; Hüttl, Artúr; Vértes, Miklós; Nguyen, Dat Tin; Bérczi, Ákos; Hüttl, Kálmán; Dósa, Edit.
Afiliação
  • Hüttl AB; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
  • Hüttl A; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
  • Vértes M; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
  • Nguyen DT; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
  • Bérczi Á; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
  • Hüttl K; Heart and Vascular Center, Semmelweis University, Budapest, Hungary.
  • Dósa E; Heart and Vascular Center, Semmelweis University, Budapest, Hungary. Electronic address: dosaedit@yahoo.com.
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.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Síndrome do Roubo Subclávio / Falha de Prótese / Stents / Angioplastia com Balão / Calcificação Vascular Idioma: En Ano de publicação: 2019 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Síndrome do Roubo Subclávio / Falha de Prótese / Stents / Angioplastia com Balão / Calcificação Vascular Idioma: En Ano de publicação: 2019 Tipo de documento: Article