ACUTE CORONARY SYNDROME-STENTS
SUMMARY
1. Stents do not cause as much dissection of the plaque and are not susceptible to elastic recoil as in angioplasty alone.
2. Stents also have a lower restenosis rate than plain angioplasty.
3. The in-stent restenosis is almost always due to neointimal hyperplasia; risk of in-stent thrombosis, particularly during the early period after placement.
4. Anti-platelet therapy is important after stent placement. Bare metal stent (BMS) requires dual anti-platelet therapy for a minimum of 30 days.
5. Drug-eluting stent (DES) are made with a metallic stent backbone supporting a polymer covering that contains a slow-releasing drug to decrease the neointimal hyperplasia.
6. DES require prolonged obligatory dual-anti-platelet therapy due to the delay in neointimalization: minimum 1 year.
Reference(s)
Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].