Can stents cause thrombosis?

Stent thrombosis is a major complication associated with stent placement in percutaneous coronary intervention (PCI). Stent thrombosis has been associated with high rates of morbidity and mortality, often leading to events of cardiac death or nonfatal myocardial infarction (MI).

Why do drug-eluting stents cause thrombosis?

Hypersensitivity reactions to the polymers used in drug-eluting stents, delayed endothelialization of the stents, and discontinuation of dual antiplatelet therapy have all been implicated in the pathophysiology of drug-eluting stents stent thrombosis.

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.

What is definite stent thrombosis?

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.

What causes stent thrombosis?

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.

When does in stent thrombosis occur?

(See “Clinical use of intracoronary bare metal stents”, section on ‘BMS compared with DES’.) 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 causes blood clots in stents?

Though stents are used to treat coronary artery disease (CAD) and its complications, including clots, stents themselves can also lead to clots. The presence of a foreign body, such as a stent, in constant contact with the blood may lead to clotting in some people.

How do you prevent blood clots after a stent?

Current American Heart Association guidelines recommend that patients who undergo PCI, a minimally invasive procedure to open clogged arteries, be prescribed dual antiplatelet therapy (DAPT) to prevent blood clots, and that they continue using the combination of aspirin and a second antiplatelet medication for at least …

Can stents get clogged?

When a part of an artery with a stent gets blocked, it’s called in-stent restenosis (ISR). When a blood clot, or thrombus, forms in a part of an artery with a stent, it’s called an in-stent thrombosis (IST).

How do you fix a failed stent?

The most common method is to maneuver a drug-coated stent wrapped around a balloon into the middle of the closed-up stent. Inflating the balloon pushes aside the material obstructing the old stent and opens the new one. This often, but not always, solves the problem for good.