Prevention of stent thrombosis: challenges and solutions

Abstract

Stent thrombosis is an uncommon but serious complication which carries with it significant mortality and morbidity. This review analyzes the entity of stent thrombosis from a historical and clinical perspective, and chronicles the evolution of this condition through the various generations of stent development, from bare metal to first-generation, second-generation, and third-generation drug-eluting stents. It also delineates the specific risk factors associated with stent thrombosis and comprehensively examines the literature related to each of these risks. Finally, it highlights the preventative strategies that can be garnered from the existing data, and concludes that a multifactorial approach is necessary to combat the occurrence of stent thrombosis, with higher risk groups, such as patients with ST segment elevation myocardial infarction, meriting further research.

Stent strut streamlining and thickness reduction promote endothelialization

“…Stent thrombosis (ST), although uncommon, remains a recognized complication of coronary stenting [1]. The formation of a thrombus within the stent, or immediately proximal or distal, can occur as early as during stent deployment to very late after deployment.…”

Very late biolimus-eluting coronary stent thrombosis: case report

“…Возможность развития столь поздних осложнений ЧКВ определяет необходимость индивидуальной оценки риска непосредственных и отдаленных тромботических событий для оптимизации антитромбоцитарной терапии. В приведенном клиническом случае у больного имела место имплантация стента второго поколения (биолимус-выделяющего), применение которого ассоциировано с минимальным риском отдаленных тромбозов, в первую очередь за счет использования биорезорбируемых полимеров в структуре [5,7,12]. Однако следует отметить, что у пациента имелись независимые ангиографические предикторы развития ТС: с учетом локализации поражения (средний сегмент ПНА), был использован стент небольшого калибра и большой протяженности (свыше 25 мм), проведена бифуркационная пластика.…”

Reforming Healthcare Practice in View of the Economic Crisis in Lebanon: The Case of Cardiovascular Care

“…45 In addition to the choice of antiplatelet and the use of drug eluting stents, patient compliance with antiplatelets is an important factor in preventing stent thrombosis. 46 Adequate physician follow up can help with patient compliance; however, many patients cannot afford follow up with private clinics. Improving care at an already established primary care center network by the MOPH can ensure adequate follow up for these patients, along with the provision of needed drugs free of charge.…”