Optimal antiplatelet and anticoagulation therapy for drug-eluting stents

The major limitations of percutaneous transluminal coronary angioplasty (PTCA) are acute vessel closure and restenosis. The advent of intracoronary stents resulted in a significant reduction in these complications.1,2

Improvements in the stent design, deployment techniques, and postinterventional antithrombotic therapy reduced the incidence of acute and subacute stent thrombosis from 20% to 1.3%.3,4 Drug-eluting stents (DES) emerged as a solution to restenosis. They dramatically reduced the incidence of restenosis but raised the question of whether there is an increase in the incidence of stent thrombosis with these newer stents. In this chapter we will review the available data on the occurrence of stent thrombosis with DES and optimal antithrombotic regimens to prevent it.