Late thrombosis of drug-eluting stents after discontinuation of clopidogrel: report of two cases and review of the literature.
Thrombosis of intracoronary stents is a major complication associated with significant morbidity and mortality. Of concern are case reports of late (more than six months from deployment) drug-eluting stent thrombosis temporally associated with discontinuation of antiplatelet therapy and when stent endothelialization was presumed to be complete. In certain patients it appears that vascular healing at the stented segments is incomplete with increased susceptibility to late thrombosis. We report two cases of late stent thrombosis occuring more than one year after stent deployment and within weeks of discontinuation of clopidogrel. A review of the literature is presented to identify clinical and angiographic predictors of increased risk.
Chrissoheris
Michael P
MP
Cardiology Fellow, Hospital of Saint Raphael, New Haven, USA.
Mruthyunjayanna
Vikram
V
Donohue
Thomas J
TJ
D000369:Aged, 80 and over; D001241:Aspirin / Q000627:therapeutic use; D000077144:Clopidogrel; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use; D011859:Radiography; D015607:Stents; D013927:Thrombosis / Q000209:etiology* / Q000628:therapy; D013988:Ticlopidine / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D013997:Time Factors; D014463:Ultrasonography
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin