Division of Cardiology, Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan.
J Cardiol. 2011 Sep;58(2):92-8. doi: 10.1016/j.jjcc.2011.07.003. Epub 2011 Aug 11.
Coronary stents have been used for the treatment of patients with coronary artery disease (CAD), and significantly improved procedural safety and are associated with a lower rate of restenosis compared with balloon angioplasty alone. Drug-eluting stents (DES) have been dominant for the treatment of CAD with efficacy in significantly reducing both restenosis and target lesion revascularization. However, late and very late stent thrombosis have become a major concern in DES-implanted arteries compared with those treated with bare-metal stents (BMS). This review focuses on the feature of DES thrombosis and pathological examination and dual antiplatelet therapy for prevention of stent thrombosis. Currently, the incidence of stent thrombosis associated with first-generation and second-generation DES remains unclear in data from real-world cohort registry studies. Further studies of larger multicenter trials would give us insight into the specific mechanisms of stent thrombosis among different generations of DES.
冠状动脉支架已被用于治疗冠状动脉疾病（CAD）患者，与单独球囊血管成形术相比，其明显提高了手术安全性，并且再狭窄率更低。药物洗脱支架（DES）在治疗 CAD 方面占据主导地位，其疗效可显著降低再狭窄和靶病变血运重建的发生率。然而，与裸金属支架（BMS）相比，DES 植入血管的迟发和极晚期支架血栓形成已成为一个主要关注点。本综述重点介绍 DES 血栓形成的特征和病理学检查，以及双重抗血小板治疗预防支架血栓形成。目前，真实世界队列注册研究的数据中，第一代和第二代 DES 相关支架血栓形成的发生率尚不清楚。进一步的大样本多中心试验研究将使我们深入了解不同代 DES 之间支架血栓形成的具体机制。
