Two cases of very late stent thrombosis after drug-eluting stent implantation demonstrated huge positive vessel remodeling leading to late-acquired incomplete stent apposition and myocardial infarction.
Case Report (n=2)
What is the mechanism of very late stent thrombosis after drug-eluting stent implantation?
Very late stent thrombosis after DES implantation may be driven by massive positive vessel remodeling leading to late-acquired incomplete stent apposition.
Stent thrombosis is a rare but potentially fatal complication of percutaneous treatment of coronary disease. Its occurrence after drug eluting stent (DES) placement has raised concerns, especially when it occurs late after the stent implantation. The mechanisms of late thrombosis after DES have yet to be completely understood. By means of serial angiography and intravascular (IVUS) images we described a relatively new and unusual vessel response to drug-eluting stents (e.g. huge positive remodeling in all vessel extension), leading to impressive late-acquired incomplete stent apposition and finally causing stent thrombosis and acute myocardial infarction. After describing the two cases, one after Cypher stent implantation and one after Taxus stent implantation, we briefly reviewed the literature available on stent thrombosis with special emphasis on its late occurrence.
Feres et al. (Thu,) conducted a case report in Stent thrombosis after drug-eluting stent placement (n=2). Drug-eluting stents (Cypher and Taxus) was evaluated. Two cases of very late stent thrombosis after drug-eluting stent implantation demonstrated huge positive vessel remodeling leading to late-acquired incomplete stent apposition and myocardial infarction.