Coronary stent thrombosis in bare metal stents

OBJECTIVE: The incidence of coronary stent thrombosis has reduced with improved techniques and drugs. Nevertheless, clinical trials may not reflect real world practice due to the selective inclusion criteria, regional variations and more complex patients treated in day-to-day practice. We examined the frequency, predisposing factors and outcome of stent thrombosis in unselected patients undergoing bare metal stents.

METHODS: All patients undergoing stent implantation are entered into a prospective database. We reviewed the incidence of stent thrombosis in our database for all patients with at least 6 months of follow up.

RESULTS: From December 1996 through to December 2002, 1140 consecutive patients underwent a coronary stenting. Stent thrombosis occurred in 9 (0.8%) patients; 7 (78%) presented within 30 days of the procedure, while 2 had late stent thrombosis occurring after 30 days. The vessel was left anterior descending artery in all, 8 (89%) had a recent anterior myocardial infarction prior to the intervention and the mean stent length was 25 mm.

CONCLUSION: The incidence of stent thrombosis is approximately 1% in the current era of intervention. Longer stent length in the left anterior descending artery following a recent myocardial infarction, seems to be associated with stent thrombosis.