Stent Thrombosis Management: IVUS-Guided Strategy and When to Use DCB

Stent thrombosis is one of the most high-stakes complications in PCI — and getting the mechanism right is everything.In this MurmurMD case discussion, Dr. Nyal Borges and Dr. Joe Walsh walk through a real-world case of stent thrombosis, focusing on how intravascular imaging (IVUS) guides diagnosis and how drug-coated balloons (DCB) fit into the treatment strategy.Key discussion points from the transcript include:• Identifying the underlying cause of stent thrombosis• Why angiography alone is insufficient in these cases• Using IVUS to detect under-expansion, malapposition, or mechanical issues• Stepwise management of thrombus and lesion preparation• When additional stenting may worsen outcomes• The role of DCB in avoiding further metal layers• Optimizing vessel expansion before definitive therapy• Real-time decision making during a complex thrombotic caseThis discussion highlights a critical principle:stent thrombosis is not just treated — it is diagnosed and corrected with imaging.🔔 Subscribe for more insights from interventional experts and real-world program builders.📱 Download the app: https://apps.apple.com/app/apple-store/id1586692687📺 Follow us on YouTube: https://www.youtube.com/channel/UCfrLYhAhliQ2ZvXinkDCZvAChapters:00:00 – Case introduction: stent thrombosis presentation 00:40 – Initial angiographic findings 01:20 – Why imaging is critical in stent thrombosis 02:10 – IVUS assessment and identifying the mechanism 03:10 – Lesion preparation and thrombus management 04:10 – Deciding against additional stenting 05:00 – Role of DCB in treatment strategy 05:50 – Final optimization and imaging confirmation 06:30 – Key lessons for managing stent thrombosis#StentThrombosis #IVUS #DCB #ComplexPCI #InterventionalCardiology #CathLab #CoronaryIntervention #MurmurMD