Drug-eluting stent thrombosis
نویسندگان
چکیده
OBJECTIVES We compared the risk of stent thrombosis (ST) after drug-eluting stents (DES) versus bare-metal stents (BMS), and tested the hypothesis that the risk of DES thrombosis is related to stent length. BACKGROUND Whether DES increase the risk of ST remains unclear. Given the very low restenosis rate after drug-eluting stenting, longer stents are frequently implanted for the same lesion length in comparison to BMS. METHODS We included in a meta-analysis 10 randomized studies comparing DES and BMS. Overall, 5,030 patients were included (2,602 were allocated to DES and 2,428 to BMS). The risk of thrombosis after DES versus BMS was compared, and the relationship between the rate of DES thrombosis and stent length was evaluated. RESULTS Incidence of ST was not increased in patients receiving DES (0.58% vs. 0.54% for BMS; odds ratio: 1.05; 95% confidence interval [CI]: 0.51 to 2.15; p 1.000). The overall rate of ST did not differ significantly between patients receiving sirolimusor paclitaxel-eluting stents (0.57% vs. 0.58%; p 1.000). We found a significant relation between the rate of ST and the stented length (Y 1.455 0.121 X; 95% CI for beta: 0.014 to 0.227; R 0.716; p 0.031). In patients with DES, mean stented length was longer in those suffering ST (23.4 8.1 mm vs. 21.3 4.1 mm, p 0.025). CONCLUSIONS Drug-eluting stents do not increase the risk of ST, at least under appropriate anti-platelet therapy. The risk of ST after DES implantation is related to stent length. (J Am Coll ublished by Elsevier Inc. doi:10.1016/j.jacc.2004.11.065
منابع مشابه
انفارکتوس راجعه میوکارد به دنبال ترومبوز بسیار دیررس در stent، گزارش یک مورد
Stent thrombosis as a complication of percutaneous coronary intervention frequently is associated with deadly events such as myocardial infarction and sudden death. Definitions of stent thrombosis have not been in a uniform manner in different clinical studies. Two episodes of acute ST elevation myocardial infarction nearly two years after implanting a drug – eluting stent in a 58-year-...
متن کاملOverview of Intracoronary Brachytherapy for in-Stent Restenosis of a Drug-Eluting Stent
Percutaneous coronary intervention with stenting is considered recently as the most common procedure for the treatment of symptomatic coronary. The article reviewed 41 studies published during 1997-2019 on intracoronary brachytherapy for in-stent restenosis of a drug-eluting stent. Intracoronary radiation therapy was finally confirmed in the setting of in-stent restenosis using as adjunctive th...
متن کاملDrug-eluting stent malapposition and its relationship to drug-eluting stent thrombosis
Stent malapposition (whether acute and persistent, or late and acquired) is common, occurring in 10–20% of drug-eluting stent implantations in stable patients and 30–40% of ST-elevated myocardial infarction patients. Acute stent malapposition is not a predictor of early stent thrombosis. Conversely, late stent malapposition, especially the large late stent malapposition area, might be a cause o...
متن کاملPerioperative management of antiplatelet therapy in patients with drug-eluting stents
Significant advancements in percutaneous treatment of coronary artery disease have been achieved with the introduction of bare metal stents. They have two major drawbacks: acute/subacute stent thrombosis, successfully managed with antiplatelet therapy immediately after stent implantation; and in-stent restenosis, prevention of which has been achieved with the development of drug-eluting stents....
متن کاملPathological Perspective of Drug-Eluting Stent Thrombosis
Although very late stent thrombosis (VLST) after drug-eluting stent (DES) implantation remains a major concern, the precise mechanisms have not been clarified. An association between late acquired incomplete stent apposition (ISA) and VLST of DES has been suggested by several intravascular ultrasound studies demonstrating very high prevalence of ISA in the setting of VLST. To clarify the pathol...
متن کامل