In-stent restenosis (ISR) occurs in 20% to 40% of de novo coronary lesions treated with bare-metal stents (BMS), depending on lesion and patient-related factors. Drug-eluting stents coated with antiproliferative agents, represent a valid rationale for treatment and prevention of recurrent ISR, with low MACE rates. However, case reports and observational studies reported a definite increase in the incidence of late stent thrombosis after drug-eluting stents use, particularly in off-label cases and after clopidogrel withdrawal. The case we present shows target vessel occlusion occurring at the site of a previously implanted BMS, suggesting that in-stent restenosis was the main pathological mechanism leading to abrupt thrombotic vessel closure and acute myocardial infarction.
Late occlusive in-stent restenosis of a bare-metal stent presenting with ST-elevation anterior MI : is restenosis better than a late stent thrombosis? / D. Trabattoni, A. Bartorelli. - In: INTERNATIONAL JOURNAL OF CARDIOLOGY. - ISSN 0167-5273. - 135:2(2009 Jun 26), pp. e65-e67.
Late occlusive in-stent restenosis of a bare-metal stent presenting with ST-elevation anterior MI : is restenosis better than a late stent thrombosis?
A. Bartorelli
2009
Abstract
In-stent restenosis (ISR) occurs in 20% to 40% of de novo coronary lesions treated with bare-metal stents (BMS), depending on lesion and patient-related factors. Drug-eluting stents coated with antiproliferative agents, represent a valid rationale for treatment and prevention of recurrent ISR, with low MACE rates. However, case reports and observational studies reported a definite increase in the incidence of late stent thrombosis after drug-eluting stents use, particularly in off-label cases and after clopidogrel withdrawal. The case we present shows target vessel occlusion occurring at the site of a previously implanted BMS, suggesting that in-stent restenosis was the main pathological mechanism leading to abrupt thrombotic vessel closure and acute myocardial infarction.Pubblicazioni consigliate
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