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Updated: Jun 28, 2026

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

[Late stent thrombosis after drug-eluting stent implantation: epidemiological, clinical and pathophysiological

Salvatore Notaristefano1, Paolo Sbarzaglia, Claudio Cavallini

  • 1S.C. di Cardiologia, Azienda Ospedaliera di Perugia, Perugia.

Giornale Italiano Di Cardiologia (2006)
|October 24, 2008
PubMed

Insights

Stent thrombosis (ST), a rare complication of percutaneous coronary intervention, may occur later with drug-eluting stents (DES). However, this very-late ST risk does not increase adverse outcomes like death or heart attack compared to bare-metal stents.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials Science

Context:

  • Stent thrombosis (ST) is a serious complication following percutaneous coronary intervention (PCI).
  • Drug-eluting stents (DES) have been associated with concerns about very-late stent thrombosis (VLST), occurring after the first year post-PCI.
  • Existing literature suggests a potential, albeit modest, increase in VLST incidence with DES compared to bare-metal stents (BMS).

Purpose:

  • To analyze the incidence and implications of very-late stent thrombosis (VLST) in patients treated with drug-eluting stents (DES) versus bare-metal stents (BMS).
  • To explore the multifactorial causes contributing to early, late, and very-late stent thrombosis.
  • To discuss current strategies and future innovations for mitigating ST risk.

Summary:

  • While data suggest a slightly higher incidence of very-late stent thrombosis (VLST) with drug-eluting stents (DES) compared to bare-metal stents (BMS) (0.35%-0.6% annually), this has not translated into worse hard outcomes (death, myocardial infarction).
  • Stent thrombosis is multifactorial, with early ST linked to procedural aspects and antiplatelet therapy, while late and very-late ST involve patient risk factors and arterial healing.
  • Current risk reduction strategies include careful patient selection, precise implantation, and ensuring patient compliance with antiplatelet therapy. Future innovations focus on novel antiplatelet agents and next-generation DES.

Impact:

  • Understanding the nuances of ST, particularly VLST with DES, is crucial for optimizing patient selection and procedural techniques.
  • The findings underscore that despite a modest increase in VLST, DES remain a safe and effective treatment option, as hard clinical outcomes are not worsened.
  • Future advancements in DES technology and antiplatelet therapies hold promise for further reducing the risk of stent thrombosis.

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