title: A case report of very late stent thrombosis observed simultaneously in all three vessels 5 years after sirolimus-eluting stent implantation.
abstract: A 67-year-old man with recent myocardial infarction underwent a total of five sirolimus-eluting stents (SES) implantation for three vessels stage by stage. A follow-up angiography showed no significant restenosis except one in the side branch. Thereafter, he had remained asymptomatic. Sixty-six months later, he had an acute myocardial infarction with cardiogenic shock due to simultaneous 3-vessel very late stent thrombosis (VLST). After successful percutaneous coronary intervention, final angiography revealed serious peri-stent contrast staining along with positive remodeling and grade V stent fracture. This rare case illustrates simultaneous 3-vessel VLST, associating with multiple SES-related problems, under continuation of aspirin and cilostazol.
authors.affiliation: Department of Cardiology, Iwate Prefectural Central Hospital, 4-1 Ueda 1-chome, Morioka, 020-0066, Japan, sig-fuk@swan.ocn.ne.jp.
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Fukui
authors.forename: Hideaki
authors.initials: H
authors.lastname: Endo
authors.forename: Sota
authors.initials: S
authors.lastname: Nakajima
authors.forename: Tohru
authors.initials: T
authors.lastname: Takahashi
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nakamura
authors.forename: Eiji
authors.initials: E
authors.lastname: Nozaki
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D008297:Male; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D011859:Radiography; D012008:Recurrence; D012770:Shock, Cardiogenic / Q000628:therapy; D020123:Sirolimus / Q000008:administration & dosage*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D010975:Platelet Aggregation Inhibitors; D020123:Sirolimus