Are carotid stent fractures clinically significant?
Manuel Garcia-Toca1, Heron E Rodriguez, Peter A Naughton
1Division of Vascular Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA.
Cardiovascular and Interventional Radiology
|March 25, 2011
Summary
Carotid stent fractures after stenting for cervical carotid occlusive disease are uncommon (7.5%) and rarely cause clinical issues. Previous neck irradiation may be a risk factor for these rare carotid stent fractures.
Area of Science:
- Vascular Surgery
- Interventional Cardiology
- Biomedical Engineering
Background:
- Late stent fatigue is a recognized complication following carotid artery stenting (CAS).
- Cervical carotid occlusive disease is a common indication for CAS.
- Understanding the prevalence and significance of carotid stent fractures is crucial for patient management.
Purpose of the Study:
- To determine the prevalence of carotid stent fractures after CAS.
- To assess the clinical significance and potential risk factors associated with these fractures.
Main Methods:
- Retrospective review of 253 CAS procedures for cervical carotid occlusive disease.
- Analysis of stent integrity using cervical plain radiographs by two independent observers.
- Fractures classified into four types; mean follow-up of 32 months.
Main Results:
- Eight fractures (7.5%) were detected in 106 nitinol stents analyzed.
- Fractures were more common in open-cell stents, but this was not statistically significant.
- A history of external beam neck irradiation was the only significant risk factor (p=0.048); no major clinical sequelae observed.
Conclusions:
- Late stent fatigue leading to carotid stent fractures is uncommon after CAS.
- Carotid stent fractures rarely have significant clinical relevance or sequelae.
- While stent cell design did not influence fracture occurrence, lesion characteristics may be risk factors.
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