Which is the “Numero uno” cause for acute stent thrombosis in real world Cath labs ?
- Hypersensitivity reaction to metals
- Poor deployment of stent
- Inadequate Anti-platelet regimen
- Drug eluting stent
Answer : 2 .(Indisputably correct )
It is estimated at-least 4 out of 10 stents we implant is sub-optimally deployed .Only a fraction of them go for complication .Coronary endothelium silently tolerates our aggression .
How to prevent this ?
- Meticulous pre procedure analysis of lesion
- Preparing the lesion if toughness is anticipated
- Personal mind application in stent size selection
- A slow , steady non aggressive PCI
- Liberal pre and post dilatations
- Judious use of IVUS and OCT ( Mind you a prolonged IVUS procedure can occasionally convert a good deployment into bad one !)
- A good quality anti-platelet regimen.