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A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis
04:30

A Murine Model of Stent Implantation in the Carotid Artery for the Study of Restenosis

Published on: May 14, 2013

Late thrombosis of sirolimus-eluting stent: a multifactorial problem

Igor Kranjec1, Andreja Cerne

  • 1Department of Cardiology, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia.

Case Reports in Medicine
|November 7, 2009
PubMed

Insights

Late stent thrombosis occurred in a young patient despite antiplatelet therapy. Factors included stent fracture and clopidogrel resistance, requiring repeat intervention and adjusted dosage.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Biomaterials

Background:

  • Sirolimus-eluting stents (SES) are widely used for coronary artery disease.
  • Percutaneous coronary intervention (PCI) is a common treatment for acute myocardial infarction (AMI).
  • Late stent thrombosis (LST) remains a rare but serious complication following PCI.

Observation:

  • A young patient developed reinfarction due to LST 9 months after SES implantation for AMI.
  • The LST was associated with a fractured stent and evidence of clopidogrel resistance.
  • Suboptimal PCI technique may have contributed to the adverse outcome.

Findings:

  • Repeat PCI successfully reopened the thrombosed stent.
  • Doubling clopidogrel dosage to 150 mg daily for one year resolved the issue.
  • The patient experienced an uneventful long-term clinical course after intervention and dose adjustment.

Implications:

  • This case highlights the importance of identifying and addressing multifactorial causes of LST.
  • Assessing for stent fracture and potential drug resistance is crucial in managing LST.
  • Optimizing PCI technique and antiplatelet therapy regimens can improve long-term outcomes.

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