In-stent restenosis and thrombosis 41 months after drug-eluting stent implantation.
Evidence indicates that very late stent thrombosis (>1 year) occurs more frequently in drug-eluting stents than in bare metal stents after discontinuation of clopidogrel. We present a case of an 83 year old man with an LAD in-stent thrombosis 41 months after stenting with a sirolimus-eluting stent in whom clopidogrel was discontinued after 6 months based on these days' guidelines. In-stent thrombus was aspirated and intracoronary ultrasound (ICUS) showed significant in-stent restenosis which had narrowed the minimal lumen diameter by 1 mm. The lesion was stented with a bare metal stent. The patient was discharged after recovery and had no recurrence of stent thrombosis in one month follow-up. We recommended indefinite dual antiplatelet therapy with aspirin and clopidogrel.
Jamshidi
Peiman
P
Toggweiler
Stefan
S
Erne
Paul
P
D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D003328:Coronary Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D008297:Male; D013997:Time Factors