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Updated: Aug 6, 2026
Ferromagnetic Bare Metal Stent for Endothelial Cell Capture and Retention
Published on: September 18, 2015
[Late thrombosis of coronary bare-metal stent--case report]
Insights
Late stent thrombosis after bare-metal stent (BMS) implantation is rare but can occur. This case highlights a BMS thrombosis 345 days post-procedure, despite dual antiplatelet therapy.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomedical Engineering
Background:
- Stent thrombosis is a critical complication following percutaneous coronary interventions (PCI).
- While most stent thrombosis occurs early, late events (>6 months) are less common, especially with bare-metal stents (BMS).
- This case examines an unusual late BMS thrombosis despite optimal medical management.
Observation:
- A 41-year-old male experienced acute myocardial infarction due to BMS thrombosis 345 days after implantation.
- The patient was on long-term dual antiplatelet therapy and had risk factors controlled.
- Initial thrombolytic therapy was unsuccessful.
Findings:
- Late BMS thrombosis can occur beyond the typical endothelialization period.
- This event underscores the potential for late stent failure even with adherence to treatment protocols.
- Rescue balloon angioplasty and drug-eluting stent (DES) implantation were required to restore coronary blood flow.
Implications:
- Highlights the need for vigilance regarding late stent thrombosis, even in seemingly stable patients.
- Suggests that alternative mechanisms or patient-specific factors may contribute to late stent thrombosis.
- Emphasizes the role of drug-eluting stents in preventing restenosis after managing late stent thrombosis.
Abstract:
Stent thrombosis remains the primary cause of death after percutaneous coronary interventions (PCI). Despite modern concepts of PCI, stent thrombosis occurs in 0.5%-2% of elective procedures and even 6% of patients with the acute coronary syndrome (ACS). Stent thrombosis most often develops within the first 48 hours after the PCI, and rarely after a week of stent implantation. Angiographically documented late (>6 months) thrombosis of coronary bare-metal stent (BMS) is rare, because the stent endothelialization is considered to be completed after four weeks of the intervention. Our patient is a 41-year old male and he had BMS thrombosis 345 days after the implantation, which was clinically manifested as an acute myocardial infarction in the inferoposterolateral localization. Stent thrombosis occurred despite a long term dual antiplatelet therapy and control of known risk factors. Thrombolytic therapy (Streptokinase in a dose of 1,500,000 IU) was not successful in reopening the occluded vessel, so the flow through the coronary artery was achieved by rescue balloon angioplasty, followed by implantation of drug eluting stent in order to prevent restenosis.
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