Stent fracture in the superficial femoral and proximal popliteal arteries: Literature summary and economic impacts

摘要

Objectives. To summarize available evidence regarding stent fracture in the femoropopliteal region. Methods. We searched PubMed, 2000-2011, using MeSH search terms "stents," "popliteal artery," and "femoral artery." Results. We identified 29 original studies reporting 0% to 65% incidence of stent fracture. Fracture-related repeat revascularization could be avoided in the absence of device failure. Recently published data suggest that even a 5% rate of fracture-related reintervention would generate $118.4 million in health care cost in the United States. These excess procedures would also result in major complications and deaths that might have been avoided in the absence of stent fracture. Conclusions. Reported incidence and clinical relevance of femoropopliteal stent fractures vary across studies. Stent fracture may lead to repeat revascularization. These reinterventions create considerable - and potentially avoidable - economic burden for patients and payers. Further, these costs are effectively invisible wherever stent fractures are not systematically documented as the reason for reintervention.