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Pathophysiology and clinical implications of late coronary thrombosis after implantation of drug eluting stents in patients with manifest atherosclerosis
Jakabčin, Jozef ; Červinka, Pavel (advisor) ; Poledne, Rudolf (referee) ; Mates, Martin (referee)
Pathophysiology and clinical implications of late coronary thrombosis after implantation of drug eluting stents in patients with manifest atherosclerosis Abstract Drug-eluting stents (DES) have markedly reduced restenosis rates compared with bare metal stents (BMS) in controlled randomized trials. Concerns have been raised about a possibly increased incidence of stent thrombosis (ST) after discontinuation of dual antiplatelet treatment compared with BMS. While a restenosis is relatively benign process, this serious complication is an issue because mortality of such event is reaching almost 50%. Among well recognized predictors of late stent thrombosis (delayed endothelisation, renal failure, bifurcation lesions, diabetes, premature antiplatelet therapy discontinuation, slow thrombus disappearance), the stent under expansion and stent deployment technique are also considered to be a contributor for development of late stent thrombosis. There was a paucity of data regarding the IVUS guidance during DES implantation. The aim of this study was to assess the role of IVUS guidance during implantation of DES on longterm outcome in patients with high clinical and angiographic risk profile. Methods: Between January 2004 and December 2005, 2110 patients underwent percutaneous coronary intervention, including 276...
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