Characteristics and Outcome of Angiographically Confirmed Stent Thrombosis

Retrospective analysis of registry data on angiographically confirmed stent thromboses recorded between 1998 and 2007. In total, 58 cases of stent thrombosis occurred, of which 15 were in drug-eluting stents. Fourteen (24.1%) stent thromboses were acute, 27 (46.6%) were subacute, 9 (15.5%) were late, and 8 (13.8%) were very late. The most common clinical presentation was ST-elevation myocardial infarction (48%-82.8%) and 3 (5.2%) patients died during admission. Balloon angioplasty was the most frequently used treatment (25%-43.1%). During follow-up (median period, 1.7 years), 9 (16.4%) patients presented with recurrence of the stent thrombosis between 5 and 166 days after the first occurrence. One patient presented with 2 recurrences and 4 (7.3%) experienced sudden death.In conclusion, stent thrombosis most frequently presented as ST-elevation myocardial infarction, which was not fatal in 95%. There is a high risk of recurrence during the following 6 months.

Registro retrospectivo de trombosis del stent con comprobación angiográfica desde 1998 a 2007. Se objetivaron 58 trombosis del stent, 15 en stent farmacoactivos; 14 (24,1%) trombosis del stent fueron agudas, 27 (46,6%) subagudas, 9 (15,5%) tardías y 8 (13,8%) muy tardías. La presentación más frecuente fue infarto con elevación del segmento ST (48-82,8%) y 3 (5,2%) pacientes murieron durante el ingreso. El tratamiento más habitual de la trombosis del stent fue la angioplastia con balón (25- 43,1%). En el seguimiento (mediana, 1,7 años), 9 pacientes presentaron recurrencias de trombosis del stent (16,4%) entre 5 y 166 días después de la primera trombosis. Un paciente presentó 2 recurrencias y 4 (7,3%), muerte súbita.La forma más habitual de presentación de la trombosis del stent fue el infarto con elevación del segmento ST y en el 95% de los casos se trató de una complicación no mortal. Hay elevado riesgo de recurrencias en los primeros 6 meses.