Stähli Barbara E, Camici Giovanni G, Tanner Felix C
Cardiovascular Research, Physiology Institute, University of Zürich, Zurich, Switzerland.
Ther Adv Cardiovasc Dis. 2009 Feb;3(1):45-52. doi: 10.1177/1753944708096280. Epub 2008 Sep 18.
Stent thrombosis is a rare complication following stent implantation; if it occurs, however, it is associated with a high morbidity and mortality. Despite reduced rates of restenosis, drug-eluting stents (DES) have not reduced the incidence of stent thrombosis as compared with bare-metal stents (BMS). Patient-, lesion-, and procedure-related factors as well as thrombogenicity of the stent itself are involved in the pathogenesis of stent thrombosis. Furthermore, early cessation of dual antiplatelet therapy correlates with an increased risk of stent thrombosis. This review focuses on clinical evidence and pathophysiological mechanisms of stent thrombosis with DES, particularly highlighting prothrombotic effects of the stent itself.
支架内血栓形成是支架植入术后一种罕见的并发症;然而,如果发生,它与高发病率和死亡率相关。尽管再狭窄率有所降低,但与裸金属支架(BMS)相比,药物洗脱支架(DES)并未降低支架内血栓形成的发生率。患者、病变和手术相关因素以及支架本身的血栓形成倾向都参与了支架内血栓形成的发病机制。此外,双联抗血小板治疗的早期中断与支架内血栓形成风险增加相关。本综述重点关注DES支架内血栓形成的临床证据和病理生理机制,尤其强调支架本身的促血栓形成作用。