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KMID : 0882420080750040383
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Korean Journal of Medicine
2008 Volume.75 No. 4 p.383 ~ p.391
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Stent thrombosis in the DES era
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Park Kyung-Woo
Kim Hyo-Soo
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Abstract
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Although drug eluting stents (DES) have mostly replaced bare metal stents (BMS) for the treatment of coronary artery
stenosis, concern has been raised regarding the possibility of increased stent thrombosis after DES implantation. Despite
the relative low frequency of ST, it is of intense interest to clinicians because of its high morbidity and mortality. There
is much controversy regarding many aspects of ST and only recently has there been a unified definition of ST proposed
by the Academic Research Consortium. We are in need of much more knowledge and insight into the risk factors and
pathophysiology of ST as well as what can be done to overcome ST. However, investigators do agree on a few points
based on various clinical trials, registry reports, and meta-analyses: 1) The frequency of ST does not seem to differ
between BMS and DES, although DES seems to be slightly more prone to late ST; 2) The incidence of ST is very low
but its consequences are potentially fatal; 3) several risk factors may be involved in the development of ST and more
studies are required to more accurately elucidate the clinical, angiographic, procedural, and maybe genetic risk factors of
ST; 4) improvements in DES design along with better adjunctive drug treatment are required in the future to improve
long term safety.
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KEYWORD
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Drug-eluting stent, Stent thrombosis
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