Key result
Late stent malapposition links to late thrombosis, but acute malapposition fails to predict early events.
Why the study?
The relationship between drug-eluting stent malapposition and stent thrombosis, particularly late and very late thrombosis, remains unclear.
Acute malapposition may not prompt immediate correction; leaves open whether targeting late malapposition reduces thrombosis.
Stent malapposition (whether acute and persistent, or late and acquired) is common, occurring in 10–20% of drug-eluting stent implantations in stable patients and 30–40% of ST-elevated myocardial infarction patients. Acute stent malapposition is not a predictor of early stent thrombosis. Conversely, late stent malapposition, especially the large late stent malapposition area, might be a cause of late stent thrombosis and very late stent thrombosis in some patients. Other causes such as vessel wall inflammation, positive vessel wall remodeling, in-stent neoatherosclerosis with plaque rupture, stent fracture and delayed re-endothelialization with uncovered stent struts may also contribute to late and very late stent thrombosis.
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Guo et al. (2012) conducted a review in Drug-eluting stent implantation. Stent malapposition was evaluated on Stent thrombosis. Stent malapposition occurs in 10-20% of stable and 30-40% of STEMI patients; late malapposition may cause late stent thrombosis, while acute malapposition does not predict early thrombosis.
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