Postmortem in situ micro-CT evaluation of coronary stent fracture

Catheter Cardiovasc Interv. 2010 Oct 1;76(4):527-31. doi: 10.1002/ccd.22498.

Abstract

Coronary stent fracture has been postulated as an important mechanism for in-stent restenosis and late-stent thrombosis. We have developed a nondestructive microcomputed tomography (micro-CT) technique to image en bloc stented arterial segments.

Case report: A 43-year-old man died of sepsis 5 months following placement of a paclitaxel-eluting stent (PES) in the left circumflex coronary artery to treat in-stent restenosis of a sirolimus-eluting stent (SES). Micro-CT three-dimensional images of the overlapping stents were notable for numerous connecting element fractures along the length of the SES. No fractures were observed in the PES. The greatest area of luminal narrowing is related to the region of most extensive stent fracture. Micro-CT of en bloc specimens provides high resolution (16 μm), three-dimensional images allowing for visualization of the stented arterial segment in a nondestructive manner.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / instrumentation*
  • Autopsy
  • Cardiovascular Agents / administration & dosage*
  • Coronary Angiography
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / therapy*
  • Drug-Eluting Stents*
  • Fatal Outcome
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Paclitaxel / administration & dosage*
  • Prosthesis Design
  • Prosthesis Failure*
  • Radiographic Image Interpretation, Computer-Assisted
  • Treatment Outcome
  • X-Ray Microtomography*

Substances

  • Cardiovascular Agents
  • Paclitaxel