1. Clinical use of Optical Coherence Tomography to identify angiographic silent stent thrombosis

    Clinical use of Optical Coherence Tomography to identify angiographic silent stent thrombosis

    Objectives: Patients previously treated with coronary stents may suffer an acute coronary syndrome (ACS) without any evidence of thrombus formation on coronary angiography (CAG). This may be due to partial, non-occlusive stent thrombosis with microembolization. In this paper we illustrate possible mechanisms both with Optical coherence tomography (OCT) and histology. Design: We present two cases with ACS from very late stent thrombosis, both previously treated with first generation drug eluting stents (DES). Results: The first patient had ACS 15 months after DES implantation. The angiogram (CAG) was near normal with slight peri-stent contrast staining. OCT revealed abnormalities including thrombus not ...

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