Faculty Opinions recommendation of Incidence and predictors of drug-eluting stent thrombosis during and after discontinuation of thienopyridine treatment.

2007 ◽  
Author(s):  
Gregor Theilmeier
Keyword(s):  
Stent Thrombosis ◽  
Drug Eluting Stent ◽  
Drug Eluting

scholarly journals Late thrombosis of coronary bare-metal stent: Case report

2006 ◽  
Vol 134 (3-4) ◽  
pp. 155-158 ◽  
Author(s):  
Svetlana Apostolovic ◽  
Zoran Perisic ◽  
Miloje Tomasevic ◽  
Goran Stankovic ◽  
Milan Pavlovic ◽  
...  
Keyword(s):  
Stent Thrombosis ◽  
Bare Metal Stent ◽  
Drug Eluting Stent ◽  
Bare Metal ◽  
Metal Stent ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Late Thrombosis ◽  
And Control

Stent thrombosis remains the primary cause of death after percutaneous coronary interventions (PCI). Despite modern concepts of PCI, stent thrombosis occurs in 0.5% -2% of elective procedures and even 6% of patients with the acute coronary syndrome (ACS). Stent thrombosis most often develops within the first 48 hours after the PCI, and rarely after a week of stent implantation. Angiographically documented late (>6 months) thrombosis of coronary bare-metal stent (BMS) is rare, because the stent endothelialization is considered to be completed after four weeks of the intervention. Our patient is a 41 year old male and he had BMS thrombosis 345 days after the implantation, which was clinically manifested as an acute myocardial infarction in the inferoposterolateral localization. Stent Clinical Centre of Serbia, Belgrade thrombosis occurred despite a long term dual antiplatelet therapy and control of known risk factors. Thrombolytic therapy (Streptokinase in a dose of 1 500 000 IU) was not successful in reopening the occluded vessel, so the flow through the coronary artery was achieved by rescue balloon angioplasty, followed by implantation of drug eluting stent in order to prevent restenosis.

scholarly journals TCT-621 Drug-Eluting Stent Event Registry of Thrombosis (DESERT): The International Drug-Eluting Stent Thrombosis Registry, Angiographic Assessment

2012 ◽  
Vol 60 (17) ◽  
pp. B180-B181 ◽  
Author(s):  
Ron Waksman ◽  
Rebecca Torguson ◽  
Kimberly Kaneshige ◽  
Ajay Kirtane ◽  
Thomas Ryan ◽  
...  
Keyword(s):  
Stent Thrombosis ◽  
Drug Eluting Stent ◽  
Drug Eluting

Abstract 4486: Stent Thrombosis After Drug-Eluting Stent Implantation: Incidence, Timing and Relation to Discontinuation of Clopidogrel Therapy Over a 4-Year Period

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Stefanie Schulz ◽  
Julia Ellert ◽  
Julia Goedel ◽  
Robert A Byrne ◽  
Raisuke Iijma ◽  
...  
Keyword(s):  
Stent Thrombosis ◽  
Cumulative Incidence ◽  
High Volume ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Time Interval ◽  
Number Of Patients ◽  
Drug Eluting ◽  
Clopidogrel Therapy ◽  
Observational Cohort

To assess the incidence, timing and relation of drug-eluting stent thrombosis (ST) to discontinuation of clopidogrel therapy. This prospective observational cohort study includes 6816 consecutive patients that underwent a successful drug-eluting stent (DES) implantation between July 2002 through December 2006 in 2 tertiary, high-volume percutaneous coronary intervention (PCI) centers in Germany. The primary end point was definite ST (ARC definition). During 4-year follow-up, 4.2% of the patient population incurred a myocardial infarction (MI), 8.6% had died and 3.1% had experienced a bleeding complication. Definite ST was observed in 73 patients, corresponding to a cumulative incidence of 1.2% at 4 years. Cumulative incidence of ST was 0.5% at 30 days and 0.8% at 1 year. In comparison to patients without ST, patients with ST carried a higher risk of MI (93% versus 3%; OR 48.5 [41.3 to 57.1]) and death (42% versus 8%; OR 5.2 [3.6 to 7.6]). Figure 1 shows the number of patients with ST in each time interval from discontinuation of clopidogrel therapy. Figure 2 depicts the cumulative incidence of ST in patients who were on clopidogrel therapy and in those who discontinued clopidogrel. The 4-year incidence of ST after DES implantation is low in high-volume PCI centers. A relevant number of ST occur early after discontinuation of clopidogrel therapy. The dependence of ST on discontinuation of clopidogrel therapy is evident during the first 6 months but not thereafter.

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