Acta Medica Medianae
Vol. 52, No 4, December, 2013
UDK 61
ISSN 0365-4478(Printed version)
ISSN 1821-2794(Online)
 

Correspondence to:

Miodrag R. Damjanović

Clinic of Cardiovascular Diseases

Clinical Center Niš,

Bulevar Dr Zorana Đinđića 48

18000 Niš, Serbia

E-mail: miodragd@ptt.rs

Original article                                                                  

UDC: 616.13-005.6-089.843

doi:10.5633/amm.2013.0401

CLINICAL AND ANGIOGRAPHIC CHARACTERISTICS OF PATIENTS WITH STENT THROMBOSIS

Miodrag Damjanović¹, Milan Pavlović^1,2, Svetlana Apostolović^1,2, Zoran Perišić^1,2, Sonja Šalinger-Martinović1,², Milan Živković¹, Nenad Božinović¹, Vladimir Miloradović^3,4, Danijela Đorđević-Radojković¹, Boris Đinđić^1,2, Goran Koraćević^1,2, Miloje Tomašević⁴, Goran Davidović^3,4, Vera Irić-Ćupić⁴

Clinic of Cardiovascular Diseases, Clinical Center Niš, Niš, Serbia¹

University of Niš, Faculty of Medicine in Niš, Niš, Serbia²

Clinic of Cardiology, Clinical Center of Kragujevac, Faculty of Medical Sciences Kragujevac, Serbiac³

Stent thrombosis (TS) after percutaneous coronary intervention (PCI) is a rare but potentially fatal complication with an incidence of 1% to over 5%. Risk factors for TS can be divided into factors related to the patient, procedure, stent type and characteristics of the lesion.

One thousand fifty-five patients who underwent PCI during 2009 and 2010 were included into the study and followed during the next year. Patients with and without definite TS formed the study (TS+) and control group (TS+), respectively.

Twenty-three patients had TS (2,2%). Early, late and very late TS were noted in 69,5%, 13,1% and 17,4% of patients, respectively. Acute myocardial infarction with ST-segment elevation was the most frequent clinical presentation (56,6%). Discontinuation of aspirin and/or clopidogrel (34.8%) and resistance to these drugs (34.7%) were the main patient-related factors for TS. A higher percentage of stenosis of lesions (92 ± 12 vs 86 ± 14), greater average stent length (19.69 vs 17.01 mm), lower pressure stent insufflation (14.84 vs. 16.02 atm) and coronary artery dissection (26.1%) were significant reasons for the occurrence of TS. Similar stent type - BMS („bare metal stents) and DES („drug eluting stents“) were applied in both of patient groups.

STEMI patients and those with impaired systolic left ventricular function are at highest risk of TS, which is reported in more than two thirds of them in the first 30 days after PCI. Discontinuation of aspirin and/or clopidogral or resistance to these drugs led to TS. Greater stent length,  small diameter of the stent ("underestimated lesion"), lower pressure insufflation and dissection of the coronary artery are the most common procedural reasons for the occurrence of TS. Type of stent (BMS and DES) had no significant effect on the occurrence of TS. Acta Medica Medianae 2013;52(4):5-11.

      Key words: percutaneous coronary intervention, stent thrombosis