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Stent deployment failure: reasons, implications, and short- and long-term outcomes
Evgenia Nikolsky1, Luis Gruberg, Sirush Pechersky
1Division of Invasive Cardiology, Rambam Medical Center and Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Summary
Stent deployment failure occurred in 3.3% of percutaneous coronary interventions (PCI), primarily due to delivery issues. However, successful re-stenting led to favorable patient outcomes, highlighting the resilience of PCI procedures.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Device Technology
Background:
- Percutaneous coronary interventions (PCI) using stents have improved cardiovascular care.
- Despite advancements, stent deployment failure remains a clinical challenge.
- Understanding failure rates and causes is crucial for optimizing PCI outcomes.
Purpose of the Study:
- To determine the frequency and causes of stent deployment failure in PCI.
- To evaluate the clinical outcomes of patients experiencing stent deployment failure.
- To assess the success of subsequent interventions after deployment failure.
Main Methods:
- Retrospective analysis of 3,537 patients undergoing stent-assisted PCI between 1997 and 2001.
- Detailed review of 5,275 attempted stent deliveries.
- Categorization of failures: delivery failure, expansion issues, premature disengagement, and embolization.
Main Results:
- Stent deployment failure occurred in 3.3% of cases (151 patients, 175 stents).
- The primary cause was failure to deliver the stent to the lesion site (92%).
- Successful re-stenting was achieved in 88.5% of cases, with favorable short- and long-term outcomes (91.2% one-year event-free survival).
Conclusions:
- Stent deployment failure is infrequent but primarily linked to delivery challenges.
- Prompt re-intervention with a new stent is often successful.
- Patients experiencing stent deployment failure can achieve favorable outcomes with successful re-stenting.