How to minimize stent thrombosis.

Case Presentation—A 58-year-old diabetic woman with stable angina pectoris (class II symptoms despite medical therapy) presented for elective cardiac catheterization after undergoing a stress test that demonstrated anterior wall ischemia at a lowmoderate workload. Coronary angiography demonstrated single-vessel disease with a 90% lesion in the left anterior descending (LAD) coronary artery (Figure, A). Treatment with percutaneous coronary intervention (PCI) was selected as a revascularization strategy, and a drug-eluting stent (DES) was deployed in the LAD without complications (Figure, B). Before discharge, a treating physician concerned about the risk for stent thrombosis assessed the patient’s platelet reactivity using point-of-care testing, which demonstrated minimal platelet response to clopidogrel. This clinician update will discuss strategies for the prevention of stent thrombosis.