{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T22:11:21Z","timestamp":1780956681160,"version":"3.54.1"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T00:00:00Z","timestamp":1618790400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction. The frequency, characteristics and clinical implications of Strut fractures (SFs) remain incompletely understood. Methods and results. A total of 185 (160 patients) newer-generation drug-eluting stents (DES) were imaged. SFs were found in 21 DES (11.4%) and were classified in four patterns: one single stacked strut (41%); two or more stacked struts (23%); deformation without gap (27%); transection (9%). In multivariable analysis, calcific and bifurcation lesions were associated with SF in DES (OR: 3.5 [1.1\u201311] and 4.0 [2.2\u20137.2], p &lt; 0.05). Device eccentricity and asymmetry as well as optical coherence tomography (OCT) features of impaired strut healing were also associated with SF. The prevalence of fractures was similar in a set of 289 bioresorbable scaffolds (BRS). In a separate series of 20 device thromboses and 36 device restenoses, the prevalence of SF was higher (61.2% of DES and 66.7% of BRS, p &lt; 0.001 for both), with a higher frequency of complex SF patterns (p &lt; 0.0001). In logistic regression analysis, fractures were a correlate of device complications (p &lt; 0.0001, OR = 24.9 [5.6\u2013111] for DES and OR = 6.0 [1.8\u201320] for BRS). Discussion. The prevalence of OCT-diagnosed SF was unexpectedly high in the setting of elective controls and it increased by about three-fold in the setting of device failure. Fractures were associated with increased lesion complexity and device asymmetry\/eccentricity and were more frequent in the setting of device failure such as restenosis and thrombosis.<\/jats:p>","DOI":"10.3390\/jcm10081765","type":"journal-article","created":{"date-parts":[[2021,4,19]],"date-time":"2021-04-19T11:21:38Z","timestamp":1618831298000},"page":"1765","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Coronary Stent Strut Fractures: Classification, Prevalence and Clinical Associations"],"prefix":"10.3390","volume":"10","author":[{"given":"Katharina","family":"Schochlow","sequence":"first","affiliation":[{"name":"Kardiologie 1, Zentrum f\u00fcr Kardiologie, Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz, Langenbeckstra\u00dfe 1, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melissa","family":"Weissner","sequence":"additional","affiliation":[{"name":"Kardiologie 1, Zentrum f\u00fcr Kardiologie, Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz, Langenbeckstra\u00dfe 1, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Blachutzik","sequence":"additional","affiliation":[{"name":"Med. Klinik 2, Universit\u00e4tsklinikum Erlangen, Ulmenweg 18, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niklas F.","family":"Boeder","sequence":"additional","affiliation":[{"name":"Med. Klinik I, Universit\u00e4tsklinikum Gie\u00dfen und Marburg GmbH, Klinikstr. 33, 35392 Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Tr\u00f6bs","sequence":"additional","affiliation":[{"name":"Med. Klinik 2, Universit\u00e4tsklinikum Erlangen, Ulmenweg 18, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liv","family":"Lorenz","sequence":"additional","affiliation":[{"name":"Kardiologie 1, Zentrum f\u00fcr Kardiologie, Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz, Langenbeckstra\u00dfe 1, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jouke","family":"Dijkstra","sequence":"additional","affiliation":[{"name":"Division of Image Processing, Department of Radiology, Leiden University Medical Center, 2300 RC Leiden, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"M\u00fcnzel","sequence":"additional","affiliation":[{"name":"Kardiologie 1, Zentrum f\u00fcr Kardiologie, Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz, Langenbeckstra\u00dfe 1, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephan","family":"Achenbach","sequence":"additional","affiliation":[{"name":"Med. Klinik 2, Universit\u00e4tsklinikum Erlangen, Ulmenweg 18, 91054 Erlangen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Holger","family":"Nef","sequence":"additional","affiliation":[{"name":"Med. Klinik I, Universit\u00e4tsklinikum Gie\u00dfen und Marburg GmbH, Klinikstr. 33, 35392 Gie\u00dfen, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tommaso","family":"Gori","sequence":"additional","affiliation":[{"name":"Kardiologie 1, Zentrum f\u00fcr Kardiologie, Universit\u00e4tsmedizin der Johannes Gutenberg-Universit\u00e4t Mainz, Langenbeckstra\u00dfe 1, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,4,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1016\/j.jacc.2019.11.058","article-title":"Stent-Related Adverse Events >1 Year After Percutaneous Coronary Intervention","volume":"75","author":"Madhavan","year":"2020","journal-title":"J. Am. Coll. 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