Late occlusive in-stent restenosis of a bare-metal stent presenting with ST-elevation anterior MI: is restenosis better than a late stent thrombosis?
In-stent restenosis (ISR) occurs in 20% to 40% of de novo coronary lesions treated with bare-metal stents (BMS), depending on lesion and patient-related factors. Drug-eluting stents coated with antiproliferative agents, represent a valid rationale for treatment and prevention of recurrent ISR, with low MACE rates. However, case reports and observational studies reported a definite increase in the incidence of late stent thrombosis after drug-eluting stents use, particularly in off-label cases and after clopidogrel withdrawal. The case we present shows target vessel occlusion occurring at the site of a previously implanted BMS, suggesting that in-stent restenosis was the main pathological mechanism leading to abrupt thrombotic vessel closure and acute myocardial infarction.
Trabattoni
Daniela
D
Bartorelli
Antonio L
AL
D000328:Adult; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging*; D003328:Coronary Thrombosis; D004562:Electrocardiography; D006801:Humans; D008297:Male; D008670:Metals; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000209:etiology; D015607:Stents / Q000009:adverse effects*
D008670:Metals