Very late thrombosis in a bare metal stent: mechanistic analysis from optical coherence tomography

Recent publications have emphasized the concept that restenosis of a bare metal stent (BMS) is not as clinically benign as previously believed. We present a case of very late stent thrombosis 9 years after implantation of a BMS is described. Optical coherence tomography shows plaque rupture in the stent. These findings suggest that the formation and progression of a neoatheroma over a previously healed intrastent vascular intima may represent a "new" mechanism for stent thrombosis. Evidence from the current case supports this hypothesis.