Korean J Med > Volume 75(4); 2008 > Article
The Korean Journal of Medicine 2008;75(4):383-391.
Stent thrombosis in the DES era
Kyung Woo Park, Hyo-Soo Kim
한림대학교 의과대학 춘천성심병원 내과, 산부인과1
특집: 약물 용출 스텐트 시대의 스텐트 혈전증
박경우 . 김효수, Hyo-Soo Kim
Abstract
Although drug eluting stents (DES) have mostly replaced bare metal stents (BMS) for the treatment of coronary artery stenosis, concern has been raised regarding the possibility of increased stent thrombosis after DES implantation. Despite the relative low frequency of ST, it is of intense interest to clinicians because of its high morbidity and mortality. There is much controversy regarding many aspects of ST and only recently has there been a unified definition of ST proposed by the Academic Research Consortium. We are in need of much more knowledge and insight into the risk factors and pathophysiology of ST as well as what can be done to overcome ST. However, investigators do agree on a few points based on various clinical trials, registry reports, and meta-analyses: 1) The frequency of ST does not seem to differ between BMS and DES, although DES seems to be slightly more prone to late ST; 2) The incidence of ST is very low but its consequences are potentially fatal; 3) several risk factors may be involved in the development of ST and more studies are required to more accurately elucidate the clinical, angiographic, procedural, and maybe genetic risk factors of ST; 4) improvements in DES design along with better adjunctive drug treatment are required in the future to improve long term safety. (Korean J Med 75:383-391, 2008)
Key Words: Drug-eluting stent; Stent thrombosis


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