Stent thrombosis is a rare but potentially life threatening complication of percutaneous coronary intervention (PCI). It develops when a blood clot blocks blood flow through your stent.

A coronary stent is an expandable metal mesh coil that helps open an artery that supplies the heart with blood. It’s used to prevent a heart attack or help improve survival after one occurs.

Stent thrombosis is a potentially serious complication in which a blood clot blocks the flow through the stent. If left untreated, this blockage can limit your heart’s blood supply and lead to a heart attack. Some people develop stent thrombosis within 24 hours of their procedure, while others may develop it a month or months later.

The main treatments for stent thrombosis are procedures to remove the blood clot and reopen your stent.

Read on to learn more about stent thrombosis, including why it occurs, treatment options, and outlook.

Stent thrombosis is a blood clot that blocks blood flow through a coronary artery stent. It’s a serious complication of procedures involving coronary stenting, such as PCI, and can lead to serious complications such as a heart attack.

Stent thrombosis is subcategorized based on how long after the procedure it occurs:

  • Acute stent thrombosis: This is a stent thrombosis that occurs within 24 hours of placement.
  • Subacute stent thrombosis: This is a stent thrombosis that occurs between 24 hours and 1 month of placement.

It may also be classified as:

  • Early stent thrombosis: You may have an early stent thrombosis if it occurs within 1 month of placement.
  • Late stent thrombosis: You may have a late stent thrombosis if it occurs between 1 and 12 months after placement.
  • Very late stent thrombosis: If it occurs more than 12 months after placement, you may have a very late stent thrombosis.

Stent thrombosis can develop quickly and cause acute coronary syndrome. Acute coronary syndrome is a sudden blockage of blood flow to your heart. This blockage can cause symptoms that might be similar to symptoms you experienced before receiving a stent. They might include:

If your heart doesn’t receive an adequate amount of blood, you may develop a heart attack. A heart attack is the most common initial sign of stent thrombosis.

Heart attack symptoms can include:

  • pain in the left side or center of your heart that lasts for more than a few minutes or goes away and comes back.
  • pain that feels like:
    • pressure
    • squeezing
    • fullness
  • weakness or faintness
  • pain in your jaw, neck, or back
  • pain in one or both your arms or shoulders
  • shortness of breath

It’s essential to get immediate medical attention if you believe you may be having a heart attack.

Stent thrombosis occurs when a blood clot forms near or inside a stent inserted into an artery in the heart to improve blood flow.

Some risk factors for stent thrombosis include:

One of the top risk factors for the development of stent thrombosis is stopping antiplatelet medications too early. You’ll usually need to continue dual antiplatelet drug therapy for a year after a drug-eluting stent placement and a month after a bare-metal stent placement.

Drug-eluting stents are a newer type that has mostly replaced bare-metal stents.

You may receive your diagnosis in an emergency room if you go to the hospital with heart attack symptoms.

Initial tests for stent thrombosis include:

  • a review of your medical history
  • a review of your symptoms
  • physical examination

If your doctor suspects that you may have a heart problem, they may order other tests such as:

The main treatment for stent thrombosis is procedures to break up the blood clot and open your stent. These procedures are generally performed by inserting a long tube called a catheter through a blood vessel, often in your groin.

The main options include:

  • Angioplasty: Angioplasty involves widening the blood vessel with a small inflatable balloon.
  • Aspiration thrombectomy: Aspiration thrombectomyinvolves using a suction device to remove the blood clot from the stent.

You may also receive stronger prescription antiplatelet drugs such as ticagrelor or prasugrel to help reduce the risk of developing another blood clot.

The death rate for stent thrombosis is relatively high due to the high risk of heart attack. Receiving prompt and proper treatment can potentially maximize your chances of survival and reduce your risk of complications.

Research indicates the 30-day death rate is between 10% and 25%.

In a 2022 study using data from Japan from 2008 to 2017, researchers reported the following all-cause mortality rates at various time points. The all-cause mortality rate measures the number of people who have passed away from any cause.

PeriodDeath rate
1-year14.6%
2-year17.4%
3-year21.2%
5-year24.4%
10-year33.8%

Is stent thrombosis life threatening?

Stent thrombosis can be life threatening and requires rapid identification and treatment. The leading cause of death is a heart attack.

How common is a stent thrombosis?

Research indicates stent thrombosis occurs in about 0.5 to 1% of people receiving newer types of stents.

Stent thrombosis is a blood clot that develops after a stent placement to improve blood in your heart. It can be a potentially life threatening complication that requires immediate treatment.

The most common treatment involves receiving a procedure to remove your blood clot and open your stent. Taking your antiplatelet drugs as prescribed after a stent placement can help reduce the risk of blood clots.

It’s important to get immediate emergency medical attention any time you develop potential side effects of stent thrombosis, such as chest pain or lightheadedness.