How is stent thrombosis treated?
Dual antiplatelet therapy with aspirin and a thienopyridine is currently recommended for PCI patients in whom stents are implanted on the basis of randomized trials showing reduced rates of stent thrombosis with aspirin plus ticlopidine compared to aspirin alone or aspirin plus warfarin.
How long should you use anticoagulation after a stent?
A substantial number of patients who undergo PCI with stent implantation after an acute myocardial infarction develop left ventricular thrombus and are at increased risk of embolism (6% to 12% annually), so anticoagulation therapy is recommended for at least 3 months for these patients.
Why does stent thrombosis occur?
The primary factors contributing to stent thrombosis are inadequate stent deployment, incomplete stent apposition, residual stenosis, unrecognized dissection impairing blood flow, and noncompliance with dual antiplatelet therapy (DAPT). Noncompliance with DAPT is the most common cause of stent thrombosis.
What causes scar tissue in stents?
Restenosis is caused by an overgrowth of scar tissue. When a stent is first placed, healthy tissue from the lining of your cell walls grows inside of it. This is good because it keeps your blood from clotting as it flows through the stent. However, scar tissue may form underneath the healthy tissue.
How is stent thrombosis diagnosed?
Consensus Definition of Stent Thrombosis—Academic Research Consortium. Definite stent thrombosis: a patient with clinical signs or symptoms of an acute coronary syndrome and angiographic or autopsy evidence of a thrombus 5 mm proximal or distal to the stent.
When does in stent thrombosis occur?
Stent thrombosis can occur acutely (within 24 hours), subacutely (within 30 days), or as late as one year (late) or more (very late) after stent placement.
What is the best blood thinner after a stent?
After drug-eluting stent placement, you need to take aspirin and a stronger prescription blood thinner such as clopidogrel (Plavix) to prevent blood clotting in the stent. You may need to take a daily aspirin for the rest of your life.
How long do you need to take Plavix after a stent?
The data “suggest that all patients with drug-eluting stents should continue to take [Plavix] for at least 12 months after [stent implantation], and possibly indefinitely,” Eisenstein and colleagues conclude.
What is the risk of stent thrombosis?
The incidence of stent thrombosis has been reported in a number of studies most of which have found an incidence of 0.5-2 %, but despite being a quantitatively minor problem, stent thrombosis has a major clinical impact owing to a high risk of myocardial infarction and death.
What are the types of stent thrombosis?
Based on the underlying stent, stent thrombosis should be divided into categories of a bare-metal stent (BMS), a first-generation drug-eluting stent (DES), and second-generation DES.
