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. 2011 Jul;41(7):417-20.
doi: 10.4070/kcj.2011.41.7.417. Epub 2011 Jul 30.

Very Late Stent Thrombosis in a Drug-Eluting Stent due to Interruption of Anti-Platelet Agents in Patients With Acute Myocardial Infarction and Thrombocytosis

Hong Sang Choi  1 , Myung Ho Jeong, Il Kook Seo, Min Goo Lee, Jum Suk Ko, Keun Ho Park, Doo Sun Sim, Nam Sik Yoon, Kye Hun Kim, Hyung Wook Park, Young Joon Hong, Ju Han Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang
Affiliations

Very Late Stent Thrombosis in a Drug-Eluting Stent due to Interruption of Anti-Platelet Agents in Patients With Acute Myocardial Infarction and Thrombocytosis

Hong Sang Choi et al. Korean Circ J. 2011 Jul.

Abstract

Stent thrombosis is a fatal complication in patients who have undergone percutaneous coronary intervention, and discontinuation of anti-platelet agent is a major risk factor of stent thrombosis. We report a rare case of very late stent thrombosis (VLST) following discontinuation of anti-platelet agents in a patient who experienced acute myocardial infarction and essential thrombocytosis. She had undergone implantation of a drug eluting stent (DES) and a bare metal stent (BMS) two and half years prior to her presentation. VLST developed in DES, not in BMS, following interruption of anti-platelet therapy.

Keywords: Drug-eluting stents; Essential thrombocythemia; Thrombosis.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Fig. 1
Fig. 1
Patient underwent percutaneous coronary intervention (PCI) in the right coronary artery (RCA) due to inferior ST elevation myocardial infarction two and a half years ago. Initial coronary angiogram revealed critical stenosis in middle RCA (95%) and distal left circumflex artery (LCX) (80%) (A and C). We deployed bare metal stent in the proximal and middle RCA (B), and drug-eluting stent in the distal LCX by staged PCI (D).
Fig. 2
Fig. 2
Electrocardiogram showed ST-segment elevation in lead II, III and aVF.
Fig. 3
Fig. 3
Emergent coronary angiogram showed thrombotic total occlusion of the distal left circumflex artery due to drug-eluting stent thrombosis (A), and patent right coronary artery bare metal stent (B).
Fig. 4
Fig. 4
Coronary angiogram after balloon dilatation showed no residual stenosis and relatively good distal flow.
See this image and copyright information in PMC

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