ABSTRACT
The initial obstacle that investigators had to overcome with these devices was the problem of stent thrombosis. Initial series showed that stent thrombosis occurred in up to 20% of all cases, leading to unacceptably high myocardial infarction (MI) and mortality rates.1 Due to this high periprocedural stent thrombosis rate, patients were treated with aggressive anticoagulation regimens, which in turn led to frequent bleeding complications. For this reason, stents were only used as a bail-out procedure, for the treatment of abrupt occlusion after balloon angioplasty.2
In 1995, Colombo and colleagues demonstrated that optimal stent expansion using a technique of high pressure balloon inflation, dramatically reduced the incidence of stent thrombosis to less than 2%.3 This technique also replaced coumadin with antiplatelet agents, ticlopidine, and aspirin, which led to a dramatic reduction in bleeding complications.
