open access

Vol 13, No 2 (2018)
Case Reports
Published online: 2018-05-30
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Longitudinal deformation of a Synergy drug eluting stent during withdrawal of a cutting balloon

Kenny Tan, Jason KK Loh, Timothy Watson
DOI: 10.5603/FC.2018.0029
·
Folia Cardiologica 2018;13(2):161-162.

open access

Vol 13, No 2 (2018)
Case Reports
Published online: 2018-05-30

Abstract

Contemporary stent platforms have reduced strut thickness and fewer connectors. This improves deliverability and conformability, at the expense of reduction in strength. Recently longitudinal shortening has been reported, often associated with adjunctive devices after stent deployment. We present an unusual, impressive case of longitudinal shortening of a previously implanted Synergy stent (Boston Scientific, MA USA), within the proximal left anterior descending artery (LAD). The patient subsequently represented with restenosis of a further stent in the mid LAD. On withdrawal of a Flextome cutting balloon catheter (Boston Scientific), this device snared and dramatically shortened the Synergy. This was successfully treated with progressive dilatation using a series of enlarging balloons and subsequent implantation of another stent (Xience Xpedition, Abbott, CA USA). This case illustrates, that despite having additional connectors to enhance longitudinal strength, Synergy is not immune from compression. Furthermore, it is imperative, that stents are sized and post-dilated appropriately to ensure complete expansion.

Abstract

Contemporary stent platforms have reduced strut thickness and fewer connectors. This improves deliverability and conformability, at the expense of reduction in strength. Recently longitudinal shortening has been reported, often associated with adjunctive devices after stent deployment. We present an unusual, impressive case of longitudinal shortening of a previously implanted Synergy stent (Boston Scientific, MA USA), within the proximal left anterior descending artery (LAD). The patient subsequently represented with restenosis of a further stent in the mid LAD. On withdrawal of a Flextome cutting balloon catheter (Boston Scientific), this device snared and dramatically shortened the Synergy. This was successfully treated with progressive dilatation using a series of enlarging balloons and subsequent implantation of another stent (Xience Xpedition, Abbott, CA USA). This case illustrates, that despite having additional connectors to enhance longitudinal strength, Synergy is not immune from compression. Furthermore, it is imperative, that stents are sized and post-dilated appropriately to ensure complete expansion.
Get Citation

Keywords

percutanoeus coronary intervention, drug-eluting stents, longitudinal compression

About this article
Title

Longitudinal deformation of a Synergy drug eluting stent during withdrawal of a cutting balloon

Journal

Folia Cardiologica

Issue

Vol 13, No 2 (2018)

Pages

161-162

Published online

2018-05-30

DOI

10.5603/FC.2018.0029

Bibliographic record

Folia Cardiologica 2018;13(2):161-162.

Keywords

percutanoeus coronary intervention
drug-eluting stents
longitudinal compression

Authors

Kenny Tan
Jason KK Loh
Timothy Watson

References (5)
  1. Ormiston JA, Dixon SR, Webster MW, et al. Stent longitudinal flexibility: a comparison of 13 stent designs before and after balloon expansion. Catheter Cardiovasc Interv. 2000; 50(1): 120–124.
  2. Kastrati A, Mehilli J, Dirschinger J, et al. Intracoronary stenting and angiographic results: strut thickness effect on restenosis outcome (ISAR-STEREO) trial. Circulation. 2001; 103(23): 2816–2821.
  3. Ormiston JA, Webber B, Webster MWI. Stent longitudinal integrity bench insights into a clinical problem. JACC Cardiovasc Interv. 2011; 4(12): 1310–1317.
  4. Williams PD, Mamas MA, Morgan KP, et al. Longitudinal stent deformation: a retrospective analysis of frequency and mechanisms. EuroIntervention. 2012; 8(2): 267–274.
  5. Ormiston JA, Webber B, Webster M. Stent longitudinal integrity. JACC: Cardiovascular Interventions. 2011; 4(12): 1310–1317.

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