Stent Thrombosis: Understanding and Managing a Critical Problem

Abstract

Coronary artery stent thrombosis (ST), defined as the thrombotic occlusion of a stented segment, is an infrequent but serious complication of percutaneous coronary intervention (PCI). The clinical consequences of ST are severe, because acute stent occlusion results in myocardial infarction and death in up to 45% of cases. Specific patient and procedural characteristics increase the risk of ST, but optimized interventional techniques and antiplatelet therapies have the potential to decrease ST and improve cardiovascular outcomes following PCI.

Recommendations for Management of Antiplatelet Therapy in Patients Undergoing Elective Noncardiac Surgery After Coronary Stent Implantation

“…26,27 Several factors other than time from stent implantation likely affect the perioperative thrombosis risk, including the initial presentation (acute coronary syndrome [ACS] or not), patient factors (such as diabetes mellitus or smoking), the anatomical complexity of the stenting procedure, and the type of surgery (Table 2). 26,27 Several factors other than time from stent implantation likely affect the perioperative thrombosis risk, including the initial presentation (acute coronary syndrome [ACS] or not), patient factors (such as diabetes mellitus or smoking), the anatomical complexity of the stenting procedure, and the type of surgery (Table 2).…”