Sirolimus-eluting stent thrombosis several years after clopidogrel discontinuation

Despite recent meta-analyses showing either similar rates or only slightly increased rates of stent thrombosis in patients with a drug-eluting stent, clinicians remain concerned about the risk of late stent thrombosis in these patients. We are reporting on a "very-very" late stent thrombosis that occurred 43 months post-implantation. We believe this represents the most delayed reported thrombosis post-sirolimus-eluting stent implantation, which might not have been preventable using even the latest FDA recommendations.