Investigating the Frequency of Stent Fracture and its Impact on in-Stent Restenosis in Patients Undergoing Carotid Artery Stenting

Abstract

Objective: This single-center study aimed to assess the incidence and predictors of carotid artery Xact stent fractures (SF) and their impact on in-stent restenosis (ISR) during long-term follow-up. Methods: A cohort of 108 patients (97 males, median age 69.4±8 months) who underwent Xact stent placement for internal carotid artery stenosis between 2013 and 2021 and were diagnosed with SFs through fluoroscopy in 2022 were included. SFs were categorized as types I-V based on fracture characteristics. Follow-up included duplex ultrasound examinations to assess stent patency. Results: The average follow-up duration was 49.2±24.3 months, with ISR observed in 10 patients. Twenty-three SFs (21.3%) were identified: type I (5 patients), type II (7 patients), type III (3 patients), type IV (6 patients), and type V (2 patients). Calcification and stent length significantly predicted SFs (p<0.001; p<0.028). Conclusion: Calcification and stent length are associated with Xact SFs, but SFs do not impact ISR during long-term follow-up.

Keywords

• internal carotid artery
• xact stents
• stent fracture
• instent restenosis