Stent Thrombosis

When you hear the term stent thrombosis, you might picture a tiny clot setting up shop inside a heart artery. Stent thrombosis, the formation of a blood clot within a coronary stent after angioplasty. Also known as in‑stent thrombosis, it can trigger a heart attack or sudden chest pain. Coronary stent, a small metal mesh placed to keep a blocked artery open is the stage, while Dual antiplatelet therapy, a combination of aspirin and a P2Y12 inhibitor used to stop platelets from clumping is the most common defense. The relationship is simple: stent thrombosis occurs when platelets ignore the therapy and build a clot, and doctors respond by tweaking medication or stent type.

Why the clot forms and how we fight it

First, the stent itself can irritate the artery wall, especially if it’s a drug‑eluting stent, a stent that slowly releases medication to prevent tissue growth. That drug lowers the risk of the artery narrowing again (restenosis) but may also delay the healing of the vessel lining, giving platelets a chance to stick together. Platelet aggregation—platelets clumping into a plug—is the biological trigger. When aggregation overpowers the antiplatelet drugs, a clot forms. This is why clinicians monitor platelet function and sometimes extend the duration of dual antiplatelet therapy. In high‑risk patients, newer agents like ticagrelor or prasugrel replace clopidogrel to achieve stronger inhibition.

Beyond medication, the procedure itself matters. Proper stent sizing, adequate lesion preparation, and avoiding oversizing reduce turbulent blood flow, which otherwise encourages clot formation. Imaging tools such as intravascular ultrasound (IVUS) or optical coherence tomography (OCT) let doctors see how well the stent apposes to the artery wall. When the fit is snug, the surface is less likely to trigger platelet activation. In other words, technical precision is a hidden ally in preventing stent thrombosis.

The patient’s own health profile adds another layer. Diabetes, chronic kidney disease, or a history of previous clotting events raise the odds. Lifestyle factors—smoking, high cholesterol, uncontrolled blood pressure—also tip the scales. For those individuals, doctors may prescribe longer courses of dual antiplatelet therapy or add anticoagulants like low‑dose rivaroxaban, balancing bleeding risk against clot risk.

When a clot does appear, the response is swift. Emergency catheterization can reopen the artery, often using a thrombectomy device or a high‑dose infusion of glycoprotein IIb/IIIa inhibitors. In severe cases, surgeons may resort to coronary artery bypass grafting (CABG). The goal is to restore blood flow before irreversible heart muscle damage occurs.

Below you’ll find a curated list of articles that dive deeper into related medicines, device choices, and practical tips for patients and clinicians alike. Whether you’re looking for the latest on antiplatelet drugs or want to understand how stent design influences clot risk, the collection gives you actionable insights you can use right away.