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Published on: August 26, 2025
Resolution of late sirolimus-eluting stent thrombosis after tirofiban treatment
Ozlem Karakurt1, Goksel Cagirci, Harun Kilic
1Department of Cardiology, Ministry of Health, Dişkapi Yildirim Beyazit Research and Education Hospital, Ankara, Turkey. ozlemkarakurt55@yahoo.com
Insights
This study shows tirofiban effectively treated very late stent thrombosis in a patient with a sirolimus-eluting stent. This finding suggests tirofiban may be a valuable treatment option for this rare but serious complication.
Area of Science:
- Cardiology
- Interventional Cardiology
- Biomedical Engineering
Background:
- Drug-eluting stents (DES), such as sirolimus-eluting stents (SES), are widely used to treat coronary artery disease.
- Very late stent thrombosis (VLST), occurring more than one year after implantation, is a rare but serious complication associated with high morbidity and mortality.
Observation:
- A 40-year-old male presented with acute chest pain and was found to have ST-segment elevations indicative of myocardial infarction.
- Coronary angiography revealed thrombosis within a sirolimus-eluting stent implanted in the circumflex artery three years prior.
Findings:
- Intravenous tirofiban infusion was administered to the patient.
- Follow-up angiography demonstrated complete resolution of the stent thrombosis.
- The patient experienced resolution of acute symptoms following treatment.
Implications:
- Tirofiban shows promise as a treatment for very late drug-eluting stent thrombosis.
- Further research is warranted to evaluate the efficacy and safety of tirofiban in larger cohorts for VLST.
- This case highlights the potential of pharmacological interventions to manage complex stent-related complications.
Abstract:
A 40-year-old male patient was admitted to the hospital with acute chest pain. A sirolimus-eluting stent (SES) had been deployed to the circumflex artery (Cx) 3 years before. Now, inferior ST-segment elevations were observed and coronary angiography revealed stent thrombosis with distal TIMI 3 grade flow in the Cx. Tirofiban infusion was administered and the control angiography 2 days later revealed complete resolution of the thrombus. Stent thrombosis is a rare but usually poor prognostic event, frequently associated with large myocardial infarction (MI) or death. Very late drug-eluting stent (DES) thrombosis remains a major problem of interventional cardiology due to its high morbidity and mortality. We conclude that tirofiban may be an interesting candidate drug for treatment of very late stent thrombosis.
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