Mechanisms of Late Drug-Eluting Stent Thrombosis

Incomplete stent apposition and poor endothelialization were implicated in this rare but serious adverse event.

Several recent studies have focused attention on the increased risk for late stent thrombosis associated with drug-eluting stents (DES; Journal Watch Cardiology Mar 14 2007). Two new studies explore possible mechanisms of such events.

In a study from Switzerland, investigators performed intravascular ultrasound (IVUS) before percutaneous coronary intervention in 13 patients with late (>1 year) DES thrombosis. The resulting images were compared with those from 144 patients who underwent routine IVUS 8 months after DES implantation and did not experience stent thrombosis during 2 years of follow-up. The patients with stent thrombosis had larger lesions and longer stents, received more stents, had a higher rate of overlapping stents (P<0.001 fo…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI