Late coronary thrombosis in paclitaxel-eluting stents. Case reports.
Drug-eluting stent (DES) implantation has reduced angiographic and clinical restenosis that actually develops in less than 10% of treated patients. DESs also tend to delay the endothelialisation process increasing the risk of stent thrombosis. Subacute stent thrombosis may complicate long-term success of coronary angioplasty; it is a sudden event and usually causes acute myocardial infarction or sudden cardiac death. Patients undergoing DES implantation should be treated with dual antiplatelet therapy for at least 3-6 months. We describe two cases presenting with ST-elevation acute myocardial infarction due to stent thrombosis that occurred late after deployment of a paclitaxel-eluting stent, after discontinuation of antiplatelet therapy. It is important, for clinical cardiologists and general practitioners, to know the potential risk of late thrombosis of DES patients and, consequently, the implications regarding management of antiplatelet therapy.
Cassin
Matteo
M
Division of Cardiology-A.R.C., S. Maria degli Angeli Hospital, Pordenone, Italy. matteo.cassin@libero.it
De Biasio
Marzia
M
Macor
Franco
F
Burelli
Claudio
C
Vendrametto
Fauzia
F
Driussi
Mauro
M
Nicolosi
Gian Luigi
GL
D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000628:therapy; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D004334:Drug Administration Schedule; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000517:prevention & control; D017239:Paclitaxel / Q000008:administration & dosage*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D011474:Prosthesis Design; D015607:Stents / Q000009:adverse effects*; D013927:Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D013997:Time Factors
D003692:Delayed-Action Preparations; D010975:Platelet Aggregation Inhibitors; D017239:Paclitaxel