View source for Prevention of coronary stent thrombosis

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The main principle of the preventive treatment for stent thrombosis is to perform the best PCI possible, including good expansion and apposition of the stent. In this context, the role of intravascular ultrasound has been studied extensively and can be helpful<ref name="pmid18550555">{{cite journal |author=Roy P, Steinberg DH, Sushinsky SJ, ''et al.'' |title=The potential clinical utility of intravascular ultrasound guidance in patients undergoing percutaneous coronary intervention with drug-eluting stents |journal=Eur. Heart J. |volume=29 |issue=15 |pages=1851–7 |year=2008 |month=August |pmid=18550555 |doi=10.1093/eurheartj/ehn249 |url=}}</ref><ref name="pmid18360858">{{cite journal |author=Gerber R, Colombo A |title=Does IVUS guidance of coronary interventions affect outcome? a prime example of the failure of randomized clinical trials |journal=Catheter Cardiovasc Interv |volume=71 |issue=5 |pages=646–54 |year=2008 |month=April |pmid=18360858 |doi=10.1002/ccd.21489 |url=}}</ref>.

Antiplatelet therapy for the preventive treatment has been extensively studied and are routinely recommended. Updated 2009 ACC/AHA guidelines for STEMI and PCI recommend continuation of clopidogrel or prasugrel for minimum 12 months after both BMS and DES. However, the data for late and very late stent thrombosis is confusing and many trials are under way to study the optimal duration of antiplatelet therapy after stent implantation.