definite stent thrombosis
Angiographically confirmed complete occlusion or flow-limiting thrombus within or adjacent to a previously implanted stent.
Full Definition
Definite stent thrombosis is the highest level of diagnostic certainty in the Academic Research Consortium classification system, requiring angiographic confirmation of complete vessel occlusion (TIMI flow 0 or 1) or flow-limiting thrombus (TIMI flow 1 or 2) within or immediately adjacent to a previously implanted stent. This diagnosis must be accompanied by clinical evidence of acute coronary syndrome, such as acute onset of ischemic symptoms, new ischemic ECG changes, or elevated cardiac biomarkers. Definite stent thrombosis can be further classified temporally as acute (≤24 hours), subacute (>24 hours to 30 days), late (>30 days to 1 year), or very late (>1 year) post-implantation. This complication is associated with high morbidity and mortality, often presenting as ST-elevation myocardial infarction. Risk factors include premature discontinuation of dual antiplatelet therapy, complex lesion characteristics, and certain patient comorbidities.
Usage
Usage note: Always specify the temporal classification when reporting definite stent thrombosis.
In Context
- "Definite stent thrombosis occurred in 0.6% of patients within 30 days." — Safety analysis report
- "The patient presented with acute STEMI due to definite stent thrombosis." — Clinical case description