Discontinuation of anti-platelet therapy 2.5 years post-stenting can lead to very late stent thrombosis in drug-eluting stents, particularly in patients with pro-thrombotic conditions like essential thrombocytosis.
May warrant prolonged antiplatelet therapy caution in prothrombotic patients with drug-eluting stents; leaves open tailored duration trials.
Stent thrombosis is a fatal complication in patients who have undergone percutaneous coronary intervention, and discontinuation of anti-platelet agent is a major risk factor of stent thrombosis. We report a rare case of very late stent thrombosis (VLST) following discontinuation of anti-platelet agents in a patient who experienced acute myocardial infarction and essential thrombocytosis. She had undergone implantation of a drug eluting stent (DES) and a bare metal stent (BMS) two and half years prior to her presentation. VLST developed in DES, not in BMS, following interruption of anti-platelet therapy.
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Choi et al. (2011) studied this question.
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