Gröger Matthias, Rottbauer Wolfgang, Keßler Mirjam
Department of Internal Medicine II, University of Ulm, 89081 Ulm, Germany.
Rev Cardiovasc Med. 2022 Nov 16;23(11):384. doi: 10.31083/j.rcm2311384. eCollection 2022 Nov.
Coronary stent fracture (SF) is a potential cause of stent failure increasing the risk for in-stent restenosis, stent thrombosis, target lesion revascularization and major adverse cardiac events. Overall incidence of SF ranges from 1.0% up to 18.6% and SF can be found in up to 60% of failed devices. Advanced imaging techniques have improved the detection of SF. However, defining the optimal therapeutic approach towards these complex lesions is challenging. This review summarizes the most important publications on the topic of SF and discusses current insights into pathophysiology, diagnostic tools, classification and therapeutic management. Furthermore, two illustrative cases of SF leading to myocardial infarction are presented, which demonstrate typical SF risk factors such as vessel angulation and hinge motion, stenting in the right coronary artery, use of long stents and multiple stent layers.
冠状动脉支架断裂（SF）是支架功能失效的一个潜在原因，会增加支架内再狭窄、支架血栓形成、靶病变血管重建以及主要不良心脏事件的风险。SF的总体发生率在1.0%至18.6%之间，在高达60%的失效装置中可发现SF。先进的成像技术提高了对SF的检测能力。然而，确定针对这些复杂病变的最佳治疗方法具有挑战性。本综述总结了关于SF主题的最重要出版物，并讨论了目前对病理生理学、诊断工具、分类和治疗管理的见解。此外，还介绍了两例导致心肌梗死的SF病例，这些病例展示了典型的SF危险因素，如血管成角和铰链运动、右冠状动脉支架置入、使用长支架和多层支架。
