This case highlights the potential risk of late stent thrombosis following clopidogrel withdrawal in patients treated with brachytherapy, particularly in the setting of aspirin resistance.
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May warrant caution with clopidogrel withdrawal after brachytherapy in aspirin nonresponders; hypothesis-generating and requires prospective confirmation.
We report on a patient presenting with late thrombosis of a stent 15 months after being treated with intracoronary brachytherapy. It occurred 17 days after clopidogrel withdrawal while maintaining treatment with aspirin. At the time of stent thrombosis, evaluation of platelet aggregation was performed, revealing a suboptimal response to aspirin. Pathophysiological insights of aspirin resistance and clinical implications are reviewed.
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Jiménez‐Quevedo et al. (2004) studied this question.
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