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Correlations between fractional flow reserve and intravascular ultrasound in patients with an ambiguous left main coronary artery stenosis Regurgitant Volume/Left Ventricular End-Diastolic Volume Ratio: Prognostic Value in Patients With Secondary Mitral Regurgitation Anticoagulation with or without Clopidogrel after Transcatheter Aortic-Valve Implantation Anticoagulation After Surgical or Transcatheter Bioprosthetic Aortic Valve Replacement Transcatheter Aortic Valve Replacement in Patients With Multivalvular Heart Disease Prospective application of pre-defined intravascular ultrasound criteria for assessment of intermediate left main coronary artery lesions results from the multicenter LITRO study 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardiovascular risk: The Task Force for the management of dyslipidaemias of the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) Why NOBLE and EXCEL Are Consistent With Each Other and With Previous Trials Accuracy of Fractional Flow Reserve Derived From Coronary Angiography Association of White Matter Hyperintensities and Cardiovascular Disease: The Importance of Microcirculatory Disease
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Review ArticleVolume 71, Issue 15, April 2018

JOURNAL：J Am Coll Cardiol. Article Link

Restenosis, Stent Thrombosis, and Bleeding Complications - Navigating Between Scylla and Charybdis

J Torrado, L Buckley, A Durán et al. Keywords: biodegradable polymers; bioresorbable vascular scaffold; bleeding; drug-eluting stent; PCI; stent restenosis; stent thrombosis

ABSTRACT

The field of interventional cardiology has significantly evolved over 40 years by overcoming several challenges. The introduction of first-generation drug-eluting stents significantly reduced the rates of restenosis, but at the expense of an increase of late stent thrombosis. Prolonged antithrombotic therapy reduced rates of stent thrombosis, but at the cost of increased bleeding. Although the advent of second-generation drug-eluting stents subsequently reduced the incidence of late stent thrombosis, its permanent nature prevents full recovery of vascular structure and function with accordant risk of very late stent failure. In the present era of interventional cardiology, the tradeoff between stent thrombosis, restenosis, and bleeding presents as a particularly complex challenge. In this review, the authors highlight major contributors of late/very late stent thrombosis while targeting stent restenosis, and they discuss evolutionary advances in stent technology and antiplatelet therapy, to further improve upon the care of patients with coronary artery disease.

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