Perspective:

This bench-top study provides an important backdrop to the recent interest in Concertina effect prompted by reports from European centers. This study suggests that attempts to increase flexibility come at the cost of longitudinal stability, and stents with too few interconnectors may be more prone to shortening; this may potentially predispose to restenosis and/or stent thrombosis, and obstruct passage of devices. The clinical implications of this, however, remain unknown since it appears to be a rare condition with only sporadic case reports. The most longitudinally stable stent (Cypher Select) is no longer available, but the other four stents (Vision, Multilink, Liberte, and Integrity) that demonstrated reasonable longitudinal stability are commonly used, have a proven record of safety and efficacy, and should be preferentially considered when longitudinal distortion may be a potential concern.