Duration of dual antiplatelet therapy after coronary artery stenting: where is the sweet spot between ischaemia and bleeding?

Permanent or transient intraluminal scaffolding of coronary arteries achieved by currently available stents effectively lowers the rate of acute vessel occlusion, persistent dissection, and restenosis. The latter complication is further reduced by local anti-proliferative drug delivery (drug eluting stent, DES), albeit delaying vascular healing with complete re-endothelialization. Blood exposed to foreign bodies may clot, which in case of coronary stent struts increases the riskof vascularocclusion (i.e. stent thrombosis, ST),myocardial infarction, and death. As ST is associated with high mortality, it is a feared complication of percutaneous coronary intervention (PCI).