Late drug-eluting stent thrombosis: importance of intravascular ultrasound.
We report two cases of late occurring drug-eluting stent thrombosis (ST) where coronary angiography failed to identify the cause but intravascular ultrasound (IVUS) revealed underlying mechanical problems with the initial stent deployment. Mechanical factors such as stent underexpansion and residual edge stenoses may be more important in the pathogenesis of late drug-eluting ST than previously recognized. Intravascular ultrasound is required to reliably detect these problems and optimize subsequent reintervention.
abmccann74@hotmail.com
Andrew
A
McCann
Andrew
A
MacIsaac
Robert J
RJ
Whitbourn
D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011237:Predictive Value of Tests; D013927:Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
D010975:Platelet Aggregation Inhibitors