Erschienen in:
13.01.2021 | Invited Review Article
Drug-eluting stent thrombosis: current and future perspectives
verfasst von:
Shoichi Kuramitsu, Shinjo Sonoda, Kenji Ando, Hiromasa Otake, Masahiro Natsuaki, Reo Anai, Yasuhiro Honda, Kazushige Kadota, Yoshio Kobayashi, Takeshi Kimura
Erschienen in:
Cardiovascular Intervention and Therapeutics
|
Ausgabe 2/2021
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Abstract
Over the past 40 years, the safety and efficacy of percutaneous coronary intervention has dramatically improved by overcoming several challenges. The introduction of drug-eluting stent (DES) in particular was a major breakthrough in interventional cardiology. Compared to bare-metal stents, first-generation DES (G1-DES) has dramatically reduced the rates of in-stent restenosis and subsequent target lesion revascularization. However, major safety concerns surrounding stent thrombosis (ST) emerged with G1-DES in clinical practice as a result of the high incidences of death, myocardial infarction, and repeat revascularization associated with ST. To overcome these limitations, second-generation DES (G2-DES) has been developed with an improved stent platform with thinner strut and biocompatible durable or biodegradable polymers. Indeed, G2-DES, when compared with G1-DES, has improved clinical outcomes by reducing the risk of late thrombotic events while maintaining anti-restenotic efficacy, whereas ST still occurs, even with the use of G2-DES. This review gives an overview of pathophysiology, risk factors, and outcomes of ST after DES implantation. Additionally, we discuss the management and prevention of ST.