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What Are the Most Common Causes of Stent Failure?

After an angioplasty procedure, some stents fail if soft tissue grows over them.
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  • Written By: Mary McMahon
  • Edited By: Shereen Skola
  • Last Modified Date: 28 October 2014
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Causes of stent failure can include poor placement, the use of bare metal stents, and mechanical fatigue. Success rates can vary by device and medical professional; people with substantial experience in stenting procedures, for example, can experience more positive patient outcomes. In some cases, stent failure happens from the start, when the device cannot be placed properly and another measure needs to be considered to address a narrowed artery.

Stents are used to address stenosis, a medical complication where the walls of an artery thicken and narrow, limiting blood supply. It is a particular concern around the heart, where interruptions in blood supply could cause a heart attack. In an angioplasty procedure, a medical professional can remove built up plaque on the wall of the artery before inserting a stent to hold it open. Stents fail if soft tissue grows over them, narrowing the artery again, or when they buckle, break, or collapse.

One potential cause of stent failure is iatrogenic, meaning that it is the doctor’s fault. Some damage to the walls of the artery can occur during placement, which increases the chance of soft tissue growth over the stent. Doctors with more experience working in advanced facilities can be more successful, as can those using devices they know well. Problems with stent design can be a factor as well; some products are hard to insert, for example, which increases the risk of tissue damage.

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Another issue is the construction of the stent. Historically, these devices were made from bare metal, which created an excellent matrix for soft tissue to grow on. Many devices now are designed to slowly secrete drugs over time to block clotting and cell growth. Drug eluting stents, as they are known, tend to experience a higher success rate. If there are concerns about stent failure, this type of device may be recommended.

Mechanical fatigue can be a factor in stent failure. Metals used in medical devices are subjected to extensive testing, but microscopic analysis of failed stents can show signs of cracks, pitting, bending, and fractures. These indicate that some metals may not be suitable for long-term use, as they could break down over time. Strain might cause the stent to fail, putting the patient at risk of a serious medical complication if the issue cannot be identified in time. When a failure is linked to obvious metal fatigue, it can be reported to a medical database, allowing regulators to monitor the ongoing safety of specific devices on the market and ultimately determining if they should remain available for sale.

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anon346115
Post 4

@anon334157: I'd like to know who wrote the answer above. Are you a doctor or in the medical field. If not, what are your sources for the information above? Thanks!

anon334157
Post 2

The stent didn't collapse. It was a stent thrombosis. She should take prasugrel or ticagrelor instead of clopidogrel.

anon239667
Post 1

My pastor was admitted to the hospital last week with a heart attack. The angiogram showed right coronary artery 100 percent blocked and a stent was placed.

She was sent home after four days, and now last night she was re-admitted because the stent collapsed (she almost died). The doctor who replaced it says it must have been her medications that caused it because both the stent and the placement were good, and this was a different doctor than the one who did first stent.

Can medication cause a stent to collapse in just a few days after placement? Really?

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