Stent thrombosis: predictors and prevention

A long list of predictors for coronary stent thrombosis (ST) has Long been known, and this list grown regularly. Despite that, the mechanisms underlying the actual moment of onset of this Major complication, which has a mortality as high as 40% and a recurrence rate as high as 19%, remain often poorly understood . The understanding of These mechanisms has led to important landmarks in the history of percutaneous coronary interventions.Today, it is known that complex interrelations among clinical factors,endothelial biology, hypersensitivity/inflammatory reactions, blood ì s rheology, platelet reactivity, clotting factors, and the stent ì s physical/mechanical properties, including their impact on blood fluid dynamic, all play a role. Although the complexity of many of these concepts makes them poorly accessible for practicing physicians, evidence shows that addressing these mechanisms has profound clinical implications. We will resume the current concepts regarding the predictors and mechanisms of stent and scaffold thrombosis and describe the resulting practical implications for decisions at the time of the procedure and during follow-up.