Circulation. 2007;115:1433-1439
Published online before print March 7, 2007, doi: 10.1161/CIRCULATIONAHA.106.666826
Published online before print March 7, 2007, doi: 10.1161/CIRCULATIONAHA.106.666826
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(Circulation. 2007;115:1433-1439.)
© 2007 American Heart Association, Inc.
Controversies in Cardiovascular Medicine |
Are drug-eluting stents associated with a higher rate of late thrombosis than bare metal stents?
Late Stent Thrombosis
A Nuisance in Both Bare Metal and Drug-Eluting Stents
From the Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.
Correspondence to Professor P.W. Serruys, MD, PhD, Thoraxcenter, Ba-583, Dr Molewaterplein 40, 3015 GD Rotterdam, Netherlands. E-mail p.w.j.c.serruys@erasmusmc.nl
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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Introduction |
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Late stent thrombosis (ST) is for us an old foe that we have tracked repeatedly throughout the history of interventional cardiology. In 1991, we made headlines by publishing in the New England Journal of Medicine a rate of early and late ST of 20% among the first 151 patients having received a wall stent.1 A few years later, when some believed that they had discovered the universal panacea for restenosis (vascular brachytherapy), we were the first to report in the literature 6 cases of late ST in 100 patients having undergone brachytherapy after stent implantation.2 At that time, this seminal observation triggered a wave of observations; the cases of late ST after brachytherapy accrued month after month until the pioneer in the field, Ron Waksman, courageously admitted in an editorial that we were "sitting on a time bomb."3 Five years later (2004), in the beginning of the drug-eluting stent (DES) era, we reported, together with Waksman’s group, the first 4 cases of late ST.4 In the following 2 years, the incidence of late ST, scrutinized by alerted clinicians, was publicized in reports that included >25 000 patients treated with DES; the incidence ranged from 0.2% in a postmarketing surveillance trial to 1.8% in a small series of multivessel stenting.5–10 Around this period, we realized that Bern and Rotterdam had somewhat diverging incidences of late ST, 0.4% and 0.9%, and we joined efforts to retrospectively assess the rate of late ST over a period of 4 years. A steady rate of
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