Arrange the percutaneous coronary interventions in order from shortest to longest aspirin plus clopidogrel therapy.

Arrange the percutaneous coronary interventions in order from shortest to longest aspirin plus clopidogrel therapy.

• A. PTCA, bare metal stent, drug eluting stent
• B. PTCA, drug eluting stent, bare metal stent
• C. Bare metal stent, PTCA, drug eluting stent
• D. Drug eluting stent, bare metal stent, PTCA

Answer: (A)

Dual antiplatelet therapy duration after PCI depends on the presence and type of stent. Without a stent, there’s no scaffold that needs protection from thrombosis, so aspirin plus clopidogrel can be used for a short, limited period. Introducing a bare-metal stent creates a temporary foreign body that must be endothelialized to reduce stent thrombosis risk, so DAPT is needed for a longer, but still relatively short, period. Drug-eluting stents delay healing further due to their anti-proliferative drugs, increasing the risk of late thrombosis if DAPT is stopped early, so the recommended duration is significantly longer. Therefore, the order from shortest to longest aspirin plus clopidogrel therapy is PTCA alone, then bare-metal stent, followed by drug-eluting stent.

Dual antiplatelet therapy duration after PCI depends on the presence and type of stent. Without a stent, there’s no scaffold that needs protection from thrombosis, so aspirin plus clopidogrel can be used for a short, limited period. Introducing a bare-metal stent creates a temporary foreign body that must be endothelialized to reduce stent thrombosis risk, so DAPT is needed for a longer, but still relatively short, period. Drug-eluting stents delay healing further due to their anti-proliferative drugs, increasing the risk of late thrombosis if DAPT is stopped early, so the recommended duration is significantly longer. Therefore, the order from shortest to longest aspirin plus clopidogrel therapy is PTCA alone, then bare-metal stent, followed by drug-eluting stent.