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Silent In-Stent Thrombosis Diagnosed by Optical Coherence Tomography and Histopathology of Directional Coronary

Yusuke Shirai1, Shinya Fujita1, Atsushi Sakamoto2

  • 1Department of Cardiology, Hamamatsu Medical Center, Hamamatsu, Japan.

JACC. Case Reports
|March 21, 2025
PubMed

A 75-year-old woman who underwent percutaneous coronary intervention using an everolimus-eluting stent showed silent in-stent occlusion. Pathological examination of the neointima, resected through directional coronary atherectomy, revealed a double-layered neointima with neointimal hyperplasia and thrombus. Stent-edge restenosis and subsequent thrombosis, related to clopidogrel resistance, likely caused the in-stent thrombotic occlusion.

Keywords:
CYP2C19 loss-of-function allelesdirectional coronary atherectomyneointimal hyperplasiaoptical coherence tomographypathologystent thrombosis

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