Bare Metal Stent Thrombosis and In-Stent Neoatherosclerosis
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چکیده
Very late stent thrombosis occurs in patients with bare metal stent implantation, although the annual incidence is much lower than that after drug-eluting stent implantation. In-stent neoatherosclerosis with ruptured plaques and thin-cap fibroatheromas has been observed in bare metal stents. Atherosclerotic plaques harvested from patients with very late stent thrombosis and those with acute coronary syndrome unrelated to stent thrombosis were histologically indistinguishable from each other; showing foamy macrophages, cholesterol crystals, and thin fibrous cap. Disruption of neoatherosclerosis inside the stents could be an important underlying mechanism of very late stent thrombosis beyond 3 years after bare metal stent implantation.
منابع مشابه
Failure Mechanisms and Neoatherosclerosis Patterns in Very Late Drug-Eluting and Bare-Metal Stent Thrombosis.
BACKGROUND There are few clinical studies on the pathophysiological mechanisms of very late stent thrombosis (VLST). We report optical coherence tomography findings in patients with VLST and compare the findings between bare-metal stents (BMS) and drug-eluting stents (DES). METHODS AND RESULTS We conducted a registry of stent thrombosis at 4 North American centers with optical coherence tomog...
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Despite the reduction in late thrombotic events with newer-generation drug-eluting stents (DES), late stent failure remains a concern following stent placement. In-stent neoatherosclerosis has emerged as an important contributing factor to late vascular complications including very late stent thrombosis and late in-stent restenosis. Histologically, neoatherosclerosis is characterized by accumul...
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