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Review
. 2021 Apr;36(2):158-168.
doi: 10.1007/s12928-021-00754-x. Epub 2021 Jan 13.

Drug-eluting stent thrombosis: current and future perspectives

Shoichi Kuramitsu  1 , Shinjo Sonoda  2 , Kenji Ando  3 , Hiromasa Otake  4 , Masahiro Natsuaki  5 , Reo Anai  2 , Yasuhiro Honda  6 , Kazushige Kadota  7 , Yoshio Kobayashi  8 , Takeshi Kimura  9
Affiliations
Review

Drug-eluting stent thrombosis: current and future perspectives

Shoichi Kuramitsu et al. Cardiovasc Interv Ther. 2021 Apr.

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.

Keywords: Drug-eluting stent; Percutaneous coronary intervention; Stent thrombosis.

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