Shedding light on the mechanisms of stent thrombosis with optical coherence tomography

Since the introduction of mechanical devices for the treatment of stenotic coronary artery disease, stent thrombosis (ST) has been an issue of major clinical concern. It is an uncommon but serious complication with high mortality and morbidity that almost always presents as death or myocardial infarction (MI), usually with electrocardiographic ST-segment elevation (1). Inadequate stent expansion and undersizing of a stent has been recognized as the main reason for acute and subacute ST (2) following stent implantation. Souteyrand et al. (3) have done a great job at confirming these findings with the use of optical coherence tomography (OCT).