Predictors of Subacute Stent Thrombosis

Abstract

Background— Factors leading to subacute stent thrombosis after percutaneous coronary intervention (PCI) have not been well established. We assessed the pre- and post-PCI intravascular ultrasound (IVUS) characteristics of subacute stent thrombosis. Methods and Results— We analyzed 7484 consecutive patients without acute myocardial infarction who were treated with PCI and stenting and underwent IVUS imaging during the intervention. Twenty-seven (0.4%) had angiographically documented subacute closure P=0.0002). In 48% of the patients, there were multiple causes in 48% (versus 3% in matched lesions, P1 of these abnormal morphologies also had reduced lumen dimensions post-PCI (final lumen Conclusions— Subacute stent thrombosis is infrequently related to the preintervention lesion characteristics. Inadequate postprocedure lumen dimensions, alone or in combination with other procedurally related abnormal lesion morphologies (dissection, thrombus, or tissue prolapse), contribute to this phenomenon.