title: Predictors and outcomes of stent thrombosis: an intravascular ultrasound registry.
abstract: OBJECTIVE
  To investigate whether intravascular ultrasound provides additional information regarding the prediction of stent thrombosis, a retrospective multicentre registry was designed to enrol patients with stent thrombosis following stent deployment under ultrasound guidance.
  
  
  RESULTS
  A total of 53 patients were enrolled (mean age 61+/-9 years) with stable angina (43%), unstable angina (36%), and post-infarct angina (21%) who underwent intracoronary stenting. The majority had balloon angioplasty alone prior to stenting (94%) with 6% also undergoing rotational atherectomy. The indication for stenting was elective (53%), suboptimal result (32%) and bailout (15%). There were 1.6+/-0.8 stents/artery with 87% undergoing high-pressure dilatation (> or =14 atmospheres). The minimum stent area was 7.7+/-2.8 mm(2)with a mean stent expansion of 81.5+/-21.9%. Overall, 94% of cases demonstrated one abnormal ultrasound finding (stent under-expansion, malapposition, inflow/outflow disease, dissection, or thrombus). Angiography demonstrated an abnormality in only 32% of cases (chi-square=30.0, P<0.001). Stent thrombosis occurred at 132+/-125 h after deployment. Myocardial infarction occurred in 67% and there was an overall mortality of 15%.
  
  
  CONCLUSIONS
  On comparison with angiography, the vast majority of stents associated with subsequent thrombosis have at least one abnormal feature by intravascular ultrasound at the time of stent deployment.
authors.affiliation: Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, California, U.S.A.
authors.forename: Neal G
authors.initials: NG
authors.lastname: Uren
authors.forename: S P
authors.initials: SP
authors.lastname: Schwarzacher
authors.forename: J A
authors.initials: JA
authors.lastname: Metz
authors.forename: D P
authors.initials: DP
authors.lastname: Lee
authors.forename: Y
authors.initials: Y
authors.lastname: Honda
authors.forename: A C
authors.initials: AC
authors.lastname: Yeung
authors.forename: P J
authors.initials: PJ
authors.lastname: Fitzgerald
authors.forename: P G
authors.initials: PG
authors.lastname: Yock
mesh_terms: D006801:Humans; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents / Q000009:adverse effects*; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000628:therapy; D018084:Ultrasonography, Interventional