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Predictors and outcomes of stent thrombosis: an intravascular ultrasound registry

Neal G Uren1, S P Schwarzacher, J A Metz

  • 1Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, U.S.A.

European Heart Journal
|January 12, 2002
PubMed

Insights

Intravascular ultrasound (IVUS) identified abnormalities in most stents linked to stent thrombosis, significantly more than angiography alone. IVUS provides crucial predictive information for stent thrombosis risk.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Medical Imaging

Background:

  • Stent thrombosis remains a serious complication following coronary stenting.
  • Predictive markers for stent thrombosis are crucial for improving patient outcomes.
  • Intracoronary imaging modalities like intravascular ultrasound (IVUS) may offer enhanced insights beyond standard angiography.

Purpose of the Study:

  • To evaluate the utility of intravascular ultrasound (IVUS) in predicting stent thrombosis.
  • To compare the diagnostic yield of IVUS versus angiography in identifying abnormalities associated with stent thrombosis.

Main Methods:

  • A retrospective multicentre registry enrolled 53 patients who experienced stent thrombosis after IVUS-guided stent deployment.
  • Patient demographics, clinical presentation, procedural details, and IVUS findings were analyzed.
  • Angiographic findings were compared with IVUS findings for abnormalities such as under-expansion, malapposition, and thrombus.

Main Results:

  • 94% of stents associated with thrombosis showed at least one abnormality on IVUS (under-expansion, malapposition, etc.).
  • Angiography detected abnormalities in only 32% of these cases (P<0.001).
  • Stent thrombosis occurred at a median of 132 hours post-deployment, with high rates of myocardial infarction (67%) and mortality (15%).

Conclusions:

  • Intravascular ultrasound is superior to angiography in detecting stent abnormalities predictive of thrombosis.
  • IVUS provides critical information at the time of stent deployment to identify high-risk stents.
  • Routine use of IVUS may help mitigate the risk of stent thrombosis.
Abstract

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