In patients treated with second- or newer-generation drug-eluting stents (DES) who require repeat revascularization, one-fifth of patients have chronic stent recoil, a new study shows. These data were reported by Yoichiro Sugizaki, MD, PhD, of the Cardiovascular Research Foundation, New York, and colleagues, in a manuscript published online in JACC: Cardiovascular Interventions. Percutaneous coronary intervention (PCI) techniques have developed significantly over the past 4 decades. Chronic stent recoil is sometimes observed, though rare, and it can cause TLR. The investigators in this study utilized serial optical coherence tomography (OCT) to examine the incidence of chronic stent recoil and its correlation with TLR in second- or newer DES. Patients underwent clinically indicated serial OCT at baseline and either at time of TLR or post-6-month follow-up. A volume reduction of >10% defined chronic stent recoil (over 10mm length centered at the maximum recoil site), without fracture or deformation or >10% reduction in cross-sectional stent area with fracture or deformation. Data for this single-center, retrospective, observational study were obtained from St. Francis Hospital in Roslyn, New York, between January 2014 and December 2022. The total number of PCIs during the study period was 26,717, and there were 11,575 OCT-guided PCIs. A total of 252 patients with 265 stented lesions (163 with TLR and 102 without TLR) were imaged by OCT at baseline and follow-up, and were used for the study. Of the lesions that underwent TLR, 21.5% had chronic stent recoil, compared with 7.8% of those who did not undergo TLR, during a medial of 16.1 months after baseline OCT. A multivariable generalized logistic mixed model demonstrated that the risk for chronic stent recoil was increased by larger maximum calcium arc (per 90 degrees, odds ratio [OR]=1.64; 95% confidence interval [CI]=1.17-2.29), greater baseline stent expansion (per 10%, OR=1.41; 95% CI=1.19-1.83) and greater stent eccentricity index (per 0.1, OR=0.61; 95% CI=0.39-0.92). In terms of association with TLR, greater chronic stent recoil (per 1 mm2, OR=0.38; 95% CI=0.28-0.51), greater in-stent tissue growth (per 1 mm2, OR=4.26; 95% CI=2.83-6.41) and baseline smaller minimum stent area (1 mm2, OR=0.38; 95% CI=0.28-0.51) were all contributors. Overall, 1 in 5 patients who received second- or newer-generation DES implantation and had TLR experienced chronic stent recoil. Chronic stent recoil was also associated with TLR. Source: Sugizaki Y, Chen YW, Tsukui T, et al. Factors associated with chronic stent recoil and its impact on revascularization: A serial optical coherence tomography study. JACC Cardiovasc Interv. 2025 April 24 (Article in press). Image Credit: PH alex aviles – stock.adobe.com