Factors Associated With Chronic Stent Recoil and its Impact on Revascularization: A Serial Optical Coherence Tomography Study.

BACKGROUND

Chronic stent recoil can vary according to both stent materials and designs.

OBJECTIVES

The authors sought to use serial optical coherence tomography (OCT) to investigate the incidence of chronic stent recoil and its impact on target lesion revascularization (TLR) in second- or newer-generation drug-eluting stent implantation.

METHODS

Patients undergoing clinically indicated serial OCT studies (baseline and either at TLR or after more than 6-month follow-up) were studied. Chronic stent recoil was defined as >10% stent volume reduction (over a 10-mm length centered at the maximum recoil site) without fracture or deformation or >10% reduction in cross-sectional stent area with fracture or deformation.

RESULTS

Chronic stent recoil occurred in 21.5% (35/163) of lesions undergoing TLR and 7.8% (8/102) of lesions not undergoing TLR during a median of 16.1 (Q1-Q3: 10.1-29.4) months following baseline OCT. In a multivariable generalized logistic mixed model, larger maximum calcium arc (per 90°, OR: 1.64; 95% CI: 1.17-2.29), greater baseline stent expansion (per 10%, OR: 1.41; 95% CI: 1.19-1.83), and greater stent eccentricity index (per 0.1, OR: 0.61; 95% CI: 0.39-0.92) were associated with an increased risk for chronic stent recoil. Greater chronic stent recoil (per 1 mm2, OR: 3.86; 95% CI: 1.57-9.48), greater in-stent tissue growth (per 1 mm2, OR: 4.26; 95% CI: 2.83-6.41), and baseline smaller minimum stent area (1 mm2, OR: 0.38; 95% CI: 0.28-0.51) were associated with TLR.

CONCLUSIONS

Chronic stent recoil after second- or new-generation drug-eluting stent implantation occurred in 1 of 5 lesions undergoing TLR and was associated with TLR.