Stent thrombosis revisited

Abstract

The choice of antithrombotic regimes after stent implantation has increased. Complication rates have improved and in-hospital stay is reduced with the less aggressive regimes. For de novo stenting in large vessels with a good result, ticlopidine plus aspirin or even aspirin alone appears attractive. The successful use of such a regimen may depend on complying with published intravascular ultrasound criteria. For patients who are at higher risk, the option appears to be ticlopidine and aspirin either alone or combined with subcutaneous low molecular weight heparin, In patients selected for established or threatened vessel closure, the old regimen using full anticoagulation should still be considered. Operators should deploy stents earlier to avert the need for true bailout stenting. We still await the truly non-thrombogenic stent that can be used in small vessels under any circumstances.