Mechanisms of Stent Failure: Lessons from IVUS and OCT
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Purpose of Review
Despite significant advances in stent design and procedural technique, stent failure remains the “Achilles’ heel” of percutaneous coronary intervention (PCI). It is important to understand the mechanism of stent failure to prevent major adverse events and improve clinical outcomes.
Two-dimensional angiography alone is insufficient for elucidating the etiology of stent failure. Intracoronary imaging modalities, including intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have evolved to guide optimal stent placement during PCI, and have enabled identification of the etiology behind stent failure.
In this review, we discuss the mechanisms of stent failure, use and limitations of intracoronary imaging (IVUS and OCT) to assess its etiology, and future directions for its use in patients undergoing coronary stent implantation.
KeywordsStent failure Percutaneous coronary intervention Intravascular ultrasound Optical coherence tomography In-stent restenosis Stent thrombosis
Compliance with Ethical Standards
Conflict of Interest
All authors declare no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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