Recurrent very late drug-eluting stent thrombosis

Int J Cardiol. 2013 Oct 9;168(4):e111-2.
Duchini M, Fournier S, Iglesias JF, Roguelov C, Muller O, Eeckhout E.

Stent thrombosis (ST) is an unusual but serious complication of percutaneous coronary intervention (PCI), potentially leading to myocardial infarction and death. ST is categorized by the time of occurrence after stent implantation: acute (< 24 h), sub-acute (< 30 days), late (< 1 year) and very late (> 1 year), and by the level of certainty: definite, probable and possible. The mechanism of ST is often multifactorial with mechanical, allergic or pharmacological (resistance to antiplatelet therapy) causes. A large cohort study described late and very late ST to occur in first generation DES at a steady annual rate of 0.4% to 0.6% up to 4 years after stent placement. Thus, it has been clearly established that the rate of very late ST (VLST) is higher with first generation DES than with BMS. In this letter, we report on 2 cases of recurrent very late angiographic ST (VAST) in first generation DES in patients where antiplatelet resistance was excluded.

References

  • Duchini M1, Fournier S, Iglesias JF, Roguelov C, Muller O, Eeckhout E. Recurrent very late drug-eluting stent thrombosis. Int J Cardiol. 2013 Oct 9;168(4):e111-2. PMID: 23988303.