Mechanisms of stent thrombosis: insights from optical coherence tomography

Although the improvement of coronary stents and medical agents has reduced adverse cardiac events in patients undergoing percutaneous coronary intervention (PCI), stent thrombosis (ST) still remains one of fatal complications of stent therapy. However, the pathophysiology of ST has not been sufficiently established yet, and factors including comorbidities such as diabetes mellitus, stent design, and patients’ response or adherence to antiplatelet therapy have had the association with ST occurrence (1,2). Recently, a large prospective registry study investigating the intravascular morphologies of coronary stents in patients suffering from ST was published (3). Using optical coherence tomography (OCT) that had higher resolution than intravascular ultrasound, the study demonstrated the underlying mechanisms of ST, helping to guide the ST treatment (3). In this article, ST-related factors focusing on coronary stents are discussed.