[Treatment after drug-eluting stent placement]

The use of drug-eluting stents (DES) in percutaneous coronary interventions (PCI) decreased the rate of restenosis and hence the need for repeat revascularization by 50-71%. DES have changed PCI. DES allow successful revascularization of anatomically challenging lesions, such as long, thin vessels, bifurcation lesions, and chronic total occlusions. A rare, but severe complication of coronary stenting is stent thrombosis, a partial or total thrombotic occlusion of the stent. The use of DES for increasingly more complex lesions, the prothrombotic effect of the antiproliferative substances, and a delayed endothelialization of DES all potentially prolong and increase the risk of stent thrombosis. Dual antiplatelet therapy for 1 year is therefore recommended after DES placement. There is currently no evidence for the efficacy and safety of routine dual antiplatelet therapy beyond 1 year. It is also recommended postponing elective surgery for 1 year and, if surgery cannot be deferred, considering continuation of acetylsalicylic acid during the perioperative period in high-risk patients with DES.

Stent placement in acute cerebral artery occlusion: use of a self-expandable intracranial stent for acute stroke treatment

Stent placement has been applied in small case series as a rescue therapy in combination with different thrombolytic agents, percutaneous balloon angioplasty (PTA), and mechanical thromboembolectomy (MT) in acute stroke treatment. These studies report a considerable mortality and a high rate of intracranial hemorrhages when balloon-mounted stents were used. This study was performed to evaluate feasibility, efficacy, and safety of intracranial artery recanalization for acute ischemic stroke using a self-expandable stent.