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Stent thrombosis is when a previously placed stent in a heart artery (coronary artery) suddenly becomes blocked by a blood clot. This can result in a heart attack or even death. In order to prevent this, it is extremely important that a patient takes all the medications prescribed after a stent is placed. Missing a dose of certain medications can increase the risk of stent thrombosis. After a stent is placed, a patient must be on 2 anti-platelet or blood thinning medications. One of the medications is aspirin. The other medication is either Plavix (clopidogrel), Effient (prasugrel), or Brilinta (ticagrelor). Everyone who has a stent should take an aspirin everyday for life if tolerated. The length of time you need to be on the second anti-platelet medication depends on a number of factors including the type of stent you had placed. A drug-coated stent requires you to be on the second blood thinning medication for at least a year. Remember, do not stop taking your medications after a stent is placed unless instructed by your doctor.
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Stent thrombosis is a rare condition that occurs when a blood clot forms on the surface of a stent, raising the risk of blood flow in an artery being reduced or cut off. After either a bare metal or drug-eluting stent is implanted, there is a small risk of stent thrombosis. The chance of forming blood clots is low (it occurs in less than one in 200 patients). However, if blood clots form, the complications can be serious. They can result in recurrent chest pain or heart attack.
To prevent clots from forming, medications that thin the blood and prevent it from clumping to form clots are prescribed to all patients - no matter which type of stent is implanted. These “anti-platelet” medications currently include aspirin and clopidogrel (Plavix) or prasugrel (Effient).
If you receive a bare metal stent, your doctor will prescribe aspirin and Plavix or Effient for at least one month after your procedure. If you receive a drug-coated, or drug-eluting, stent, current recommendations are to continue daily aspirin and Plavix or Effient for at least a year after your procedure.
When a stent is used to open a blocked artery, sometimes a new blood clot --called a thrombosis -- forms around the stent and reblocks the artery. Learn how to help prevent this complication from Alvin Haynes, MD, of Regional Medical Center of San Jose.
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