Author + information
- Mohammmed Edrees Alomar,
- Tesfaldet T. Michael,
- Bavana V. Rangan,
- Subhash Banerjee and
- Emmanouil S. Brilakis
Stent loss is an infrequent but potentially grave complication of percutaneous coronary intervention (PCI). We performed a systematic review to determine the frequency, treatment and consequences of stent loss during PCI.
We identified and reviewed all published literature in English on stent loss between 1991 and 2012. We used articles that contained data on number of patients/PCIs, number of lost stents, clinical presentations, mechanisms of stent loss, management strategies and clinical outcomes.
Between 1991 and 2012, 18 case series and 45 case reports were published on stent loss. Overall, a total of 1048 stents were lost in 968 PCIs. In the 18 case series, stent loss occurred in 919 of 71,655 PCIs (2.4%, 95% confidence interval 1.1% to 3.7%). The incidence of stent loss was 5% in studies published before 2000, 1% between 2000 and 2005, and 0.3% after 2005 (p< 0.0001). The most common mechanism of loss was target vessel calcification and/or tortuosity in 347 cases (36%). Of the 1048 lost stents, 698 (66.4%) were successfully retrieved from the coronary circulation: 381 (55%) were removed from the body and 317(45%) were lost in the peripheral circulation. A total of 130 (12%) stents were deployed, 27 (3%) were crushed and 28 (2.6%) stents were left undeployed/uncrushed. The treatment of 165 (16%) stents was not reported. A complication occurred in 189 of 968 patients (20%): coronary artery bypass graft surgery 107(51%), myocardial infarction 43(20%), death 33 (16%), bleeding requiring transfusion 11(5%), dissection 9(4%), vascular surgery 2 (1%) and other complications 6 (3%) (some patients had more than one event).
The incidence of stent loss during PCI is low and has been steadily decreasing. Although the lost stents were successfully retrieved in the majority of cases, stent loss was associated with high rates of complications, such as coronary artery bypass graft surgery, myocardial infarction and death.
Poster Sessions, Expo North
Saturday, March 09, 2013, 10:00 a.m.–10:45 a.m.
Session Title: Coronary Stents
Abstract Category: 47. TCT@ACC–i2: Coronary Intervention, Devices
Presentation Number: 2101–227
- 2013 American College of Cardiology Foundation