Late stent thrombosis in drug-eluting stents: return of the' VB syndrome'

摘要

In the 1990s, when vascular brachytherapy (VB) was proposed as the definitive 'cure' for restenosis, we embraced the technology with great enthusiasm, but quickly discovered that there was a dark side. Our study group was the first to report an abnormal incidence of late thrombosis in the post-VB population, triggering a wave of reports. The late complication rate, the complexity of the procedure's logistics and the advent of the drug-eluting stent (DES) killed off VB in its infancy. Even the pioneers of the technique recognized that we were sitting on a time bomb. At the European Society of Cardiology (ESC) annual meeting in Barcelona this year, we experienced a revival of the 'VB syndrome', only this time DESs were at the center of the dispute. The ESC newsletter ran a headline of "Do drug-eluting stents increase deaths?" So, what are the facts?