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Updated: Aug 30, 2026
A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
Published on: May 14, 2013
Late stent thrombosis after implantation of a sirolimus-eluting stent
Arthur Kerner1, Luis Gruberg, Michael Kapeliovich
1Division of Invasive Cardiology, Rambam Medical Center, Technion-Israel Institute of Technology, Haifa, Israel.
Insights
Late stent thrombosis is rare but serious. This case details a sirolimus-eluting stent thrombosis causing heart attack weeks after stopping clopidogrel, a first for this stent type.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomaterials Science
Background:
- Late stent thrombosis (LST) is a rare but severe complication following percutaneous coronary intervention.
- Routine high-pressure stent deployment and dual antiplatelet therapy (DAPT) with thienopyridines and aspirin have reduced LST incidence.
- Sirolimus-eluting stents (SES) are widely used, but LST remains a concern.
Observation:
- A patient presented with acute myocardial infarction (MI) due to LST.
- The LST occurred 6 weeks after SES implantation.
- Clopidogrel discontinuation occurred 2 weeks prior to the event.
Findings:
- This case represents the first reported instance of LST specifically involving a sirolimus-eluting stent.
- The thrombosis occurred despite a relatively short interval after stent implantation and after cessation of a key component of DAPT.
Implications:
- This case highlights the potential for LST even with modern stent technology and DAPT protocols.
- It underscores the critical importance of DAPT adherence and careful consideration of its duration, especially in patients with SES.
- Further research is warranted to elucidate mechanisms and optimize management strategies for LST in SES recipients.
Abstract:
Late stent thrombosis in the era of routine high-pressure stent deployment and combined antiplatelet therapy with thienopyridines and aspirin has become a rare but feared complication. We describe a patient with acute myocardial infarction due to late stent thrombosis 6 weeks after deployment of a sirolimus-eluting stent and 2 weeks after the discontinuation of clopidogrel. This is the first report of late thrombosis of a sirolimus-eluting stent.