[Clinical features of late stent thrombosis after successful sirolimus-eluting stent implantation].
OBJECTIVE
To analyze the potential risk factors for patients developing late stent thrombosis (LST) after successful sirolimus-eluting stents (SES) implantation.


METHODS
The clinical, angiographic, procedural as well as antiplatelet therapy data were retrospectively analyzed in 8 patients with LST after successful SES implantation.


RESULTS
The patient's mean age was (51 +/- 10) years old and indication for SESs was mostly acute coronary syndrome with multiple risk factors of cardiovascular diseases. There was 1 chronic heart failure patient and renal function was normal in all patients. Multivessel diseases and complex coronary lesions including total occlusion lesions, bifurcation lesions and long lesions were seen in these patients. The mean release pressure of stents was (11.60 +/- 1.65) atm and with no high-pressure dilation after the procedure. The median time of dual antiplatelet therapy was (157.5 +/- 41.7) days. The mean duration from SESs implantation to thrombosis was (450.3 +/- 344.7) days. LST developed in 2 patients with active dual antiplatelet therapy, 1 patient at 7 days and 5 patients at 6 months after clopidogrel withdraw, 5 patients presented nonfatal acute myocardial infarction, 1 patient died of acute myocardial infarction after coronary artery bypass grafting. Five patients were successfully treated with second SESs implantations and another one was treated medically.


CONCLUSIONS
LST could be safe and effective treated with re-SESs. The development of LST after successful SESs implantation were probably associated with the following factors: (1) acute coronary syndrome with multiple risk factors of cardiovascular diseases and multivessel diseases with complex coronary lesions. (2) Low-pressure deployment without high-pressure dilation after the release. (3) Dual antiplatelet therapy withdraw.
He
Ji-Qiang
JQ
Department of Cardiology, Beijing Anzhen Hospital of the Capital University of Medical Sciences and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing 100029, China.
Chen
Fang
F
Zhang
Xiao-Ling
XL
D000328:Adult; D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects*; D003328:Coronary Thrombosis / Q000209:etiology*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage / Q000009:adverse effects*
D020123:Sirolimus