What Is Stent Thrombosis?

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In-stent restenosis (ISR) increases the risk of vascular injury and endometrial hyperplasia in the implanted segment compared with balloon dilation. This is the main cause of in-stent restenosis after bare stent implantation. Vascular wall injury after PCI causes related inflammation and promotes the proliferation of fibroblasts and smooth muscle cells, which is the mechanism of in-stent restenosis. These include: acute or subacute plaque shedding; vascular wall elastic retraction; vascular remodeling; intimal hyperplasia; intra-stent atherosclerosis. Angiography showed that restenosis of lumen diameter > 50% after stent implantation could be defined as in-stent restenosis. Intravascular imaging can provide three-dimensional images, and stent restenosis is indicated if more than 75% of new intraluminal stenosis is found.  In addition, in-stent restenosis also includes clinical symptoms requiring re-treatment, such as ischemic attacks. The pathological process of restenosis in stents caused by bare stents is mainly intimal hyperplasia, proliferation of a large number of smooth muscle cells and increased secretion of extracellular matrix. Early stent thrombosis occurs within 30 days after stent implantation and late stent thrombosis occurs 30 days after stent implantation.  Usually 50%-70% of stent thrombosis is early stent thrombosis.  Once suspected of stent thrombosis, hospitalized patients should undergo coronary angiography immediately to confirm stent thrombosis, PTCA and/or thrombus aspiration should be given immediately, and stent implantation is often recommended when there is obvious residual stenosis or dissection. IVUS and OCT intraluminal imaging examination are necessary in the treatment of stent thrombosis. The causes of stent thrombosis can be clarified, and the lesions covered by stents, the presence or absence of dissection near and distal stents, and the adherence of stents can be understood. Under this guidance, more targeted treatment measures can be given to ensure the effect. Out-of-hospital