Coronary stents constitute the default strategy during percutaneous coronary intervention (PCI) as they provide improved safety and efficacy compared with balloon angioplasty alone. Stents reduce restenosis rates compared to balloon angioplasty predominantly as a result of a larger acute gain that translates into a greater minimal lumen diameter at follow-up. Although neointimal proliferation is increased after bare metal stent (BMS) implantation, eventually the net lumen gain at follow-up is larger than that obtained with balloon angioplasty. Drug-eluting stents (DES) significantly reduced neointimal proliferation and the need for reinterventions as compared with BMS. In addition, the safety of PCI improved after the introduction of coronary stents that drastically reduced the incidence of abrupt vessel closure. However, stent thrombosis still remains an important and feared complication. This entity has a wide chronological spectrum encompassing anywhere from intra-procedural to many years after implantation.
KeywordsStent thrombosis Interventional cardiology Coronary angiography Intravascular ultrasound Optical coherence tomography
- 3.Cultip DE, Windecker S, Mehran R. Academic Research Consortium. Clinical end points in coronary stent trials: a case for standardized definitions. Circulation. 2007;115:1208–13.Google Scholar
- 6.Levine GN, Bates ER, Blankenship JC. ACCF/AHA/SCAI guideline for percutaneous coronary intervention: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol. 2011;58:e44–e122.CrossRefPubMedGoogle Scholar
- 22.Wiviott SD, Braunwald E, Angiolillo DJ. Greater clinical benefict of more intensive oral antiplatelet therapy with prasugrel in patients with diabetes mellitus in the trial to assess improvement in therapeutic outcomes by optimizing platelet inhibition with prasugrel – thrombolysis in myocardial infarction 38. Circulation. 2008;118:1626–36.CrossRefPubMedGoogle Scholar