Mechanisms of Stent Failure: Lessons from IVUS and OCT

  • Poonam Velagapudi
  • Majid Asawaeer
  • Andrew M. Goldsweig
  • Fawaz Alenezi
  • Yiannis Chatzizisis
  • Herbert D. Aronow
  • J. Dawn AbbottEmail author
Intravascular Imaging (A Truesdell, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Intravascular Imaging


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.

Recent Findings

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.


Stent 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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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Poonam Velagapudi
    • 1
  • Majid Asawaeer
    • 1
  • Andrew M. Goldsweig
    • 1
  • Fawaz Alenezi
    • 2
  • Yiannis Chatzizisis
    • 1
  • Herbert D. Aronow
    • 3
  • J. Dawn Abbott
    • 3
    Email author
  1. 1.University of Nebraska Medical CenterOmahaUSA
  2. 2.Duke University Medical CenterDurhamUSA
  3. 3.Division of Cardiovascular Medicine, Department of Internal MedicineBrown UniversityProvidenceUSA

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