Antiplatelet Drug Regimen in Patients With Stent Thrombosis　― Insights From the PESTO French Optical Coherence Tomography Registry ―

Abstract

Thrombosis) French multicenter prospective observational registry reported that a stent mechanical abnormality was present in 97% of subjects with ST explored by intracoronary optical coherence tomography (OCT) imaging. 5 Premature discontinuation and incomplete individual response to APT have previously been reported as major risk factors for ST. 6,7 However, the interactions between APT regimen and potential underlying stent abnormalities remain largely unknown, even though different mechanical substrates could favor a rheological environment that might promote thrombosis. For example, uncovered/poorly healed struts behave as foreign bodies that induce platelet A lthough its frequency has decreased over the recent past years, stent thrombosis (ST) remains a major complication of percutaneous coronary interventions (PCI) and still carries a high mortality. 1 ST is a multifaceted process that can be triggered by different factors such as the patient's clinical characteristics, efficacy of antiplatelet therapy (APT) or underlying mechanical stent abnormalities. 2 However, coronary angiography has limited sensitivity to correctly identify these latter mechanisms and recent studies suggest that intracoronary imaging is a valuable option to achieve this purpose.