Safety and efficacy of the drug-eluting stent: a double-edged sword?

Like the introduction of bare metal stents (BMS), that of drug-eluting stents (DES) represented a quantum leap in the interventional cardiology community's ongoing efforts to conquer restenosis. However, recent concerns over late thrombosis (LT) have tempered the initial enthusiasm. Nonetheless, when compared with BMS, the slightly higher DES-LT is counterbalanced by the device's markedly lower incidence of restenosis, resulting in net equivalent rates of death, myocardial infarction, and overall major adverse cardiovascular events.

Late angiographic stent thrombosis (LAST): the cloud behind the drug-eluting stent silver lining?

The introduction of drug-eluting stents (DES), like that of bare-metal stents during the balloon angioplasty era, represents yet another quantum advancement towards overcoming the challenges of restenosis. However, recent concerns over late angiographic stent thrombosis (LAST) have tempered the initial enthusiasm. Although the main time frame of thrombosis is believed to be within the first 6 months, later occurrences have been increasingly reported.

Compression of anomalous right coronary artery between the great vessels.

Coronary angiography (Figure-1) and computerized tomographic angiography (CTA) (Figure-2) of a 61-year-old man with exertional angina demonstrated proximal compression by the great vessels of an anomalous right coronary arising from the left main trunk. A significant left anterior descending lesion was also present. The patient underwent uneventful bypass surgery.