The evolution of antithrombotic therapy in coronary stenting.

A rare but important side effect associated with the use of coronary stents is the development of subacute thrombotic occlusion within the first week after implantation. Recent studies have indicated that the incidence of subacute thrombosis can be reduced with a combination regimen consisting of aspirin and ticlopidine instead of the standard regimen of aspirin and warfarin. The evolution in our understanding of the factors causing subacute stent thrombosis, coupled with the development of new implantation procedures, has permitted the development of a new treatment strategy with less aggressive anticoagulation therapy, fewer side effects, and, it is hoped, lower costs.