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Intracoronary thrombus formation after drug-eluting stents implantation: optical coherence tomographic study

Jung-Sun Kim1, Myeong-Ki Hong, Chunyu Fan

  • 1Division of Cardiology, Yonsei Cardiovascular Center, Yonsei University College of Medicine, Seoul, South Korea.

American Heart Journal
|February 16, 2010
PubMed

Insights

Intracoronary thrombus after drug-eluting stent (DES) implantation is linked to stent characteristics. Longer, smaller diameter, and uncovered struts on DES increase thrombus risk, suggesting stent design is key.

Area of Science:

  • Cardiovascular Research
  • Interventional Cardiology
  • Biomedical Engineering

Background:

  • Intracoronary thrombus formation following drug-eluting stent (DES) implantation requires further investigation.
  • Understanding thrombus development is crucial for improving stent safety and patient outcomes.

Purpose of the Study:

  • To investigate the incidence and determinants of intracoronary thrombus after DES implantation.
  • To identify specific stent characteristics associated with thrombus formation.

Main Methods:

  • Optical coherence tomography (OCT) was utilized in 226 patients with 244 DES (sirolimus-eluting, paclitaxel-eluting, zotarolimus-eluting).
  • Analysis included stent length, diameter, lesion location (bifurcation), uncovered stent struts, and malapposition.

Main Results:

  • Intracoronary thrombus was detected in 14% of patients, with higher incidence in sirolimus-eluting stents.
  • Determinants included longer stent length (≥28 mm), smaller stent diameter (<3.0 mm), and ≥8 uncovered struts.
  • Increased uncovered and malapposed stent struts were significantly associated with thrombus presence.

Conclusions:

  • Stent length, diameter, and type are significant factors in intracoronary thrombus formation post-DES implantation.
  • These stent-specific characteristics appear more influential than clinical factors.
  • Findings may guide future DES selection and design to minimize thrombus risk.
Abstract

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