[Treatment after drug-eluting stent placement].
The use of drug-eluting stents (DES) in percutaneous coronary interventions (PCI) decreased the rate of restenosis and hence the need for repeat revascularization by 50-71%. DES have changed PCI. DES allow successful revascularization of anatomically challenging lesions, such as long, thin vessels, bifurcation lesions, and chronic total occlusions. A rare, but severe complication of coronary stenting is stent thrombosis, a partial or total thrombotic occlusion of the stent. The use of DES for increasingly more complex lesions, the prothrombotic effect of the antiproliferative substances, and a delayed endothelialization of DES all potentially prolong and increase the risk of stent thrombosis. Dual antiplatelet therapy for 1 year is therefore recommended after DES placement. There is currently no evidence for the efficacy and safety of routine dual antiplatelet therapy beyond 1 year. It is also recommended postponing elective surgery for 1 year and, if surgery cannot be deferred, considering continuation of acetylsalicylic acid during the perioperative period in high-risk patients with DES.
Eberli
Franz R
FR
Klinik für Kardiologie, Universitätsspital Zürich, Rämistrasse 100, 8091, Zürich, Schweiz. franz.eberli@usz.ch
Roffi
Marco
M
D001807:Blood Vessel Prosthesis / Q000706:statistics & numerical data*; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D004343:Drug Implants; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007166:Immunosuppressive Agents; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D015607:Stents / Q000706:statistics & numerical data*; D013927:Thrombosis / Q000401:mortality*
D004343:Drug Implants; D007166:Immunosuppressive Agents