Cheneau et al identified factors associated with subacute stent thrombosis using intravascular ultrasound (IVUS). The authors are from the Washington Hospital Center in Washington, D.C., and the Cardiovascular Research Foundation in New York City.


Subacute stent thrombosis is recurrent ischemia with documented vessel occlusion within 7 days after a successful percutaneous intervention at the site of a stent placement.


A successful percutaneous intervention (PCI):

(1) post-treatment with antegrade TIMI-3 flow

(2) angiographic residual stenosis < 50%.


The mean reference diameter is the mean of arterial diameters for several segments before and after the lesion.


percent diameter stenosis =

= 100% * (1 - ((minimal lumen diameter in mm)/ (mean reference diameter in mm)))


Risk factors for subacute stent thrombosis:

(1) noncalcified lesion

(2) inadequate luminal expansion after the PCI (minimal luminal area)


Reference Area (Diameter)

Minimal Luminal Area as Percent of Reference Area (MUSIC criteria)

<= 9.0 square mm (<= 3.38 mm)

< 90%

> 9.0 square mm (> 3.38 mm)

< 80%


Causes for stent thrombosis - one or more of the following:

(1) dissection

(2) thrombus

(3) tissue protrusion within the stent struts


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