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Stent loss and retrieval during percutaneous coronary interventions: a systematic review and meta-analysis.
MedLine Citation:
PMID:  24296383     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
OBJECTIVE: We present a systematic review and meta-analysis of the frequency, consequences, and treatment of stent loss during percutaneous coronary intervention (PCI).
BACKGROUND: Stent loss during PCI has received limited study.
METHODS: We conducted a meta-analysis of 18 case series and 45 case reports published between 1991 and 2012 on stent loss during PCI. Data on the frequency of stent loss, treatment strategies, and clinical outcomes were collected.
RESULTS: A total of 1048 stents were lost in 968 PCIs. Stent loss occurred in 919 of 71,655 PCIs (1.3%; 95% confidence interval, 0.8%-2.8%). The incidence of stent loss in studies published before 2000, between 2000 and 2005, and after 2005 was 5%, 1%, and 0.3%, respectively (P<.001). Of the 1048 lost stents, 698 (66%) were successfully retrieved from the coronary circulation, 130 (12%) were deployed, 27 (3%) were crushed, and 28 (3%) were left untreated; treatment of 165 stents (16%) was not reported. A complication occurred in 171 patients (19%), of whom 98 (57%) had coronary artery bypass graft surgery, 31 (18%) myocardial infarction, 33 (19%) died, 10 (6%) had bleeding requiring transfusion, 5 (3%) had vascular access complications, and 1 patient (0.6%) had a cerebrovascular accident (some patients had more than one event).
CONCLUSIONS: The incidence of stent loss during PCI is low and has been decreasing. Although the lost stents were successfully retrieved in most cases, stent loss was associated with high rates of complications, such as coronary artery bypass graft surgery, myocardial infarction, and death.
Authors:
Mohammed E Alomar; Tesfaldet T Michael; Vishal G Patel; Clara G Altomare; Bavana V Rangan; Daisha Cipher; Subhash Banerjee; Emmanouil S Brilakis
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  25     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2013 Dec 
Date Detail:
Created Date:  2013-12-03     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  637-41     Citation Subset:  IM    
Affiliation:
VA North Texas Health Care System, The University of Texas Southwestern Medical Center at Dallas, Division of Cardiology (111A), 4500 S. Lancaster Rd, Dallas, TX 75216 USA. esbrilakis@gmail.com.
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