Stent thrombosis: a contemporary guide to definitions, risk factors, and management

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomedical Engineering

Background:

• Stent thrombosis is a significant complication after percutaneous coronary intervention (PCI).
• Despite advancements, definite or probable stent thrombosis occurs in ~0.5% of PCI cases, carrying substantial morbidity and mortality.
• Subacute and very late stent thrombosis are the most common types.

Purpose of the Study:

• To review definitions, classifications, pathophysiology, and risk factors of stent thrombosis.
• To discuss current prevention and management strategies.
• To examine advancements in stent technology and pharmacologic interventions.

Main Methods:

• Literature review of stent thrombosis.
• Analysis of real-world registry data on stent thrombosis incidence and outcomes.
• Exploration of clinical consequences, risk factors, and patient characteristics.
• Examination of procedural variables and lesion complexity.
• Review of recurrent stent thrombosis concerns.

Main Results:

• Stent thrombosis occurs in approximately 0.5% of PCI cases.
• 30-day mortality approaches 25%, with long-term risk exceeding 30% at 10 years.
• Subacute and very late stent thrombosis are most prevalent.
• Clinical consequences include myocardial infarction, emergent revascularization, and heightened cardiovascular risk.

Conclusions:

• Stent thrombosis necessitates timely recognition and intervention.
• A multidisciplinary approach is crucial for mitigating stent thrombosis incidence.
• Continued advancements in stent technology and pharmacotherapy are vital for improving patient outcomes.