Emerging thrombotic effects of drug eluting stents.

Drug eluting stents (DES) have been enthusiastically introduced into contemporary interventional cardiology practice. By delivering locally active doses of antiproliferative drugs, they have demonstrated an impressive capacity to inhibit restenosis caused by neointimal hyperplasia; a complication that has plagued uncoated “bare-metal” stents (BMS). DES coated with either paclitaxel or rapamycin (sirolimus) are now deployed in over 90% of coronary interventions in the United States.1 However, clinical follow-up has revealed significant concerns relating to the incidence of late ( 30 days) stent thrombosis, especially in long stents and after discontinuation of dual antiplatelet therapy.2