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Very Late Stent Thrombosis

  • Tom AdriaenssensEmail author
Chapter

Abstract

Although not occurring frequently, ST still remains an important clinical problem, given the important morbidity and mortality associated with the condition. With its high spatial resolution, OCT has established itself as the imaging modality of choice for this problem. Three large registries clearly documented the value of OCT in diagnosing underlying mechanisms of ST, regardless the time since initial stent implantation. With respect to VLST, the dominant role of neoatherosclerosis (lipid degeneration of the neointima) was the most striking finding of these studies. The role of delayed healing, evidenced as the persistence of uncovered and malapposed struts, and of stent underexpansion, was confirmed as well.

The use of OCT in the setting of PCI in cases of ST enables a correct diagnosis and a patient-specific therapy. Furthermore, the technology is indispensable for augmenting our understanding of stent healing biology and for the design and subsequent follow-up of new-generation intracoronary devices.

Keywords

Very late stent thrombosis Delayed healing Neoatherosclerosis Stent underexpansion Malapposed struts Uncovered struts Scaffold thrombosis 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Adjunct-Kliniekhoofd Cardiologie, Acute and Interventional CardiologyLeuvenBelgium

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