Factors promoting stent thrombosis following surgery

Factors promoting stent thrombosis following surgery

The most important factor promoting stent thrombosis following non cardiac surgery is the withdrawal of antiplatelet agents. Another important factor is that surgery induces a prothrombotic and proinflammatory state. This is mediated by release of cytokines, neuroendocrine inflammatory mediators, platelet adhesiveness, elevated high platelet counts, and impaired fibrinolysis. These factors together increase the chance of stent thrombosis in the vulnerable period during which the stent has not been fully endothelialized. This vulnerable period is longer with drug eluting stents, lasting at least one year. As the bare metal stents get endothelialized earlier, the chance for thrombosis of these stents is lesser.