title: Very late thrombosis after drug-eluting stents.
abstract: Stent thrombosis is a rare but potentially fatal complication of percutaneous treatment of coronary disease. Its occurrence after drug eluting stent (DES) placement has raised concerns, especially when it occurs late after the stent implantation. The mechanisms of late thrombosis after DES have yet to be completely understood. By means of serial angiography and intravascular (IVUS) images we described a relatively new and unusual vessel response to drug-eluting stents (e.g. huge positive remodeling in all vessel extension), leading to impressive late-acquired incomplete stent apposition and finally causing stent thrombosis and acute myocardial infarction. After describing the two cases, one after Cypher stent implantation and one after Taxus stent implantation, we briefly reviewed the literature available on stent thrombosis with special emphasis on its late occurrence.
authors.affiliation: Institute Dante Pazzanese of Cardiology, São Paulo, Brazil.
authors.forename: Fausto
authors.initials: F
authors.lastname: Feres
authors.forename: J Ribamar
authors.initials: JR
authors.lastname: Costa
authors.forename: Alexandre
authors.initials: A
authors.lastname: Abizaid
mesh_terms: D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000209:etiology*; D003331:Coronary Vessels / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D017239:Paclitaxel / Q000008:administration & dosage / Q000009:adverse effects*; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects*; D015607:Stents / Q000009:adverse effects*; D013997:Time Factors; D018084:Ultrasonography, Interventional
chemical_list: D017239:Paclitaxel; D020123:Sirolimus