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Which is the “Numero Uno” cause for acute stent thrombosis in real world cath labs ?

Posted Sep 29 2012 11:29am

Which is the “Numero uno”  cause  for  acute stent thrombosis  in real world  Cath labs ?

  1. Hypersensitivity  reaction  to metals
  2. Poor deployment of stent
  3. Inadequate  Anti-platelet  regimen
  4. Drug eluting stent

Answer :  2 .(Indisputably  correct )

It is estimated  at-least 4 out of 10 stents  we implant  is  sub-optimally  deployed .Only a fraction of them go for complication .Coronary endothelium silently  tolerates our  aggression .

How to  prevent this ?

  • Meticulous pre procedure analysis of lesion
  • Preparing the lesion if toughness is anticipated
  • Personal  mind application in stent size  selection
  • A slow , steady  non aggressive PCI
  • Liberal  pre and post dilatations
  • Judious use of IVUS and OCT ( Mind  you a  prolonged  IVUS procedure  can occasionally convert a good deployment into bad one !)
  • A  good quality anti-platelet regimen.

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