Clinical Analysis Of Stent Thrombosis After Drug-eluting Implantation

BackgroundDrug-eluting stents(DES)was developed to reduce the stent restenosis and reducing the rate of target lesion reascularization,but stent thrombosis is still a major problem in the medical industry,How to prevent stent thrombosis has always been a hot topic in the field of cardiovascular interventional therapy.ObjectiveTo analysis the features of the patients with stent thrombosis after previous implantation of drug-eluting stent and discuss the risk factors and preventive measures for the drug-eluting stents thrombosis after percutaneous coronary intervention.MethodsCollected 1335 patients who underwent PCI in the first affiliated of Zhenghou University from January 2016 to January 2017,31 patients of all occurred stent thrombosis,analysis clinical feature and related characteristics of percutaneous coronary intervention,200 patients with coronary angiography at the same period and no stent thrombosis were randomly selected as the control group.ResultsOf 1335 patients,31 cases had different degrees of stent thrombosis at different times(incidence 2.22%).There was no statistically significant difference in hypertension,alcohol consumption,smoking,and drug treatment between the stent thrombosis group and the no-stent thrombosis group.Two groups of patients with previous myocardial infarction(P = 0.001),left cardiac insufficiency(P = 0.003),acute infarction(P = 0.002),stent thrombosis group is significantly higher than the stent thrombosis group,the difference has statistical significance.In the intervention related factors,compared with the no-stent thrombosis group,stent thrombosis group had higher 3 coronary lesions(P = 0.002),anterior descending branch stent implanted(P = 0.001),type B2 lesion(P = 0.001),type C lesions(P = 0.035)than those of stent thrombosis group,the difference is statistically significant.Multiariable logistic regression analysis showed that the male(P = 0.024),previous myocardial infarction(P = 0.003),smoking(P = 0.006),the degree of vascular stenosis(P = 0.025),stent diameter(P = 0.006)was risk factors for stent thrombosis occurred after drug-eluting stent implantation.Of all the patients with stent thrombosis,25 patients showed typical clinical manifestations,changes in myocardial enzymes and electrocardiogram,and 1 patient died of repeated occurrence of stent thrombosis due to ineffective rescue.ConclusionStent thrombosis is still a common complication after drug-eluting stent implantation,with low incidence but high mortality.Stent thrombosis after drug-eluting stent implantation may be related to the formation of male,smoking,failed to control high blood pressure and other risk factors and severe left cardiac insufficiency,preious myocardial infarction,acute myocardial infarction(AMI)anterior descending branch lesions,complex blood vessel lesions,small diameter long stents,etc.