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Articles

Title: Very late stent thrombosis as a complication of incomplete drug-eluting stent apposition

Author:
Maciej M. Pawlak, Marek F. Roik
Type:
Review articles
Language:
PL
Journal:
Polish Journal of Cardiology
Year:
2010
Volume:
12
Number:
2
Start page:
139
Final page:
144
ISSN:
1507-5540
Keywords:
stent thrombosis, drug-eluting stent, incomplete stent apposition
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Very late stent thrombosis (VLST) may occur after drug-eluting stent (DES) implantation. Many papers consider about causes of this adverse cardiac event. Incomplete stent apposition (ISA) of DES is believed to be one of the in-stent thrombosis trigger. ISA is defined as a lack of contact between stent struts and the underlying vessel wall, best described by intracoronary ultrasound (ICUS). This new and not well known phenomenon is observed rela- tively more frequently in patients with DES implantation compared with BMS implantation. This paper review presents current definition and classifi- cation of stent thrombosis, risk factors that causes VLST, and the connection between very late stent thrombosis and incomplete DES apposition. We also present the classification, most important studies data about ISA incidence, and possible mechanisms leading to stent strut separation from the arterial wall. Additionally, the possible stent thrombosis treatment algorithms in patients with diagnosed stent apposition is described.