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Stent thrombosis: historical perspectives and current trends
1Cardiology Unit, The University of Rochester Medical Center, Rochester, New York 14642, USA. donald_cutlip@urmc.rochester.edu
Journal of Thrombosis and Thrombolysis
|August 18, 2000
Summary
Coronary stent thrombosis rates have decreased due to modern deployment and anti-platelet strategies. Optimal therapy involves emergent revascularization and anti-thrombotic treatment for stent thrombosis.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomaterials Science
Background:
- Coronary stents are utilized in over 70% of percutaneous coronary revascularization procedures.
- Initial concerns regarding stent thrombosis and bleeding complications have evolved with treatment advancements.
Observation:
- High-pressure stent deployment and anti-platelet regimens have reduced stent thrombosis to ~1%.
- Stent thrombosis now occurs earlier, with a median of 1 day post-procedure.
- Risk factors include multiple stents, residual dissection, and smaller final lumen size.
Findings:
- Modern strategies significantly lower stent thrombosis incidence without increasing bleeding risk.
- Earlier stent thrombosis timing necessitates prompt recognition and intervention.
- Platelet glycoprotein IIb/IIIa inhibitors may further mitigate thrombosis in high-risk cases.
Implications:
- Continued optimization of stent deployment and anti-thrombotic therapy is crucial.
- Understanding evolving risk factors aids in preventing stent thrombosis.
- Prompt treatment of stent thrombosis, though challenging, remains critical for patient outcomes.