Recurrent very late drug-eluting stent thrombosis

Area of Science:

• Cardiology
• Interventional Cardiology
• Biomedical Engineering

Background:

• In-stent thrombosis (ST) is a severe complication following stent implantation.
• While early ST incidence is similar for bare metal and drug-eluting stents (DESs), late and very late ST predominantly affects DESs.
• Predictors for late ST include patient adherence to medical therapy and optimal stent implantation technique.

Observation:

• This report details three cases of recurrent very late ST involving first-generation DESs.
• The patients were middle-aged with varying degrees of coronary artery disease.
• All presented with acute myocardial infarction.

Findings:

• Recurrent very late ST is a documented, albeit rare, event.
• First-generation DESs appear susceptible to very late thrombosis, even after extended periods.
• The cases underscore the long-term risks associated with DES implantation.

Implications:

• Further research is needed to understand the mechanisms of recurrent very late ST.
• Optimal patient selection and long-term surveillance strategies for DES recipients may be warranted.
• This highlights the importance of continued medical therapy adherence and monitoring for late stent-related events.