Table of Contents
ISRN Cardiology
Volume 2013, Article ID 748736, 8 pages
Review Article

Risk Factors for Coronary Drug-Eluting Stent Thrombosis: Influence of Procedural, Patient, Lesion, and Stent Related Factors and Dual Antiplatelet Therapy

1Abbott Vascular, Inc., Santa Clara, 3200 Lakeside Dr., Santa Clara, CA 95054-2807, USA
2Center for Cardiovascular Technology, Stanford University, Palo Alto, CA 94305-5637, USA
3The Care Group, LLC, St. Vincent Heart Center of Indiana, Indianapolis, IN 46290, USA

Received 20 May 2013; Accepted 6 June 2013

Academic Editors: A. Becker and F. Cademartiri

Copyright © 2013 Krishnankutty Sudhir et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The complication of stent thrombosis (ST) emerged at a rate of 0.5% annually for first-generation drug-eluting stents (DES), often presenting as death or myocardial infarction. Procedural factors such as stent underexpansion and malapposition are risk factors for ST in patients. The type of lesion being treated and lesion morphology also influence healing after treatment with DES and can contribute to ST. Second-generation DES such as the XIENCE V everolimus-eluting stent differ from the first-generation stents with respect to antiproliferative agents, coating technologies, and stent frame. Improvements in stent structure have resulted in a more complete endothelialization, thereby decreasing the incidence of ST. Bioresorbable scaffolds show promise for restoring vasomotor function and minimizing rates of very late ST. Post-PCI treatment with aspirin and clopidogrel for a year is currently the standard of care for DES, but high-risk patients may benefit from more potent antiplatelet agents. The optimal duration of DAPT for DES is currently unclear and will be addressed in large-scale randomized clinical trials.