Late Stent Thrombosis Following Implantation of a Drug Eluting Stent Presenting as Acute Myocardial Infarction: A Case Report

10.5580/192 ◽  
2007 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Case Report ◽  
Stent Thrombosis ◽  
Drug Eluting Stent ◽  
Late Stent Thrombosis ◽  
Drug Eluting

scholarly journals Extremely Late Stent Thrombosis in a First Generation Drug- Eluting Stent 10 Years After Stent Deployment: A Case Report

2021 ◽  
Vol 36 (2) ◽  
pp. 164-168
Author(s):  
Fazila Tun Nesa Malik ◽  
- Md Kalimuddin ◽  
Nazir Ahmed ◽  
Mohammad Badiuzzaman
Keyword(s):  
Case Report ◽  
Stent Thrombosis ◽  
First Generation ◽  
Case Reports ◽  
Drug Eluting Stent ◽  
Late Stent Thrombosis ◽  
Stent Deployment ◽  
St Segment Elevation ◽  
First Case ◽  
Drug Eluting

Stent thrombosis is one of the gravest complications of percutaneous coronary intervention which usually manifest as ST-segment elevation myocardial infarction or sudden death. There are a very few case reports in the literature regarding extremely late stent thrombosis in a drug-eluting stent. Here we report a case of extremely late stent thrombosis in a first generation drug-eluting stent in a 54 year old gentleman. To the best of our knowledge, this is the first case report with the longest duration (10 years) after sirolimus eluting first-generation DES in Bangladesh. Bangladesh Heart Journal 2021; 36(2): 164-168

Composition of thrombi in late drug-eluting stent thrombosis versus de novo acute myocardial infarction

2010 ◽  
Vol 126 (3) ◽  
pp. 254-257 ◽  
Author(s):  
Kensaku Nishihira ◽  
Atsushi Yamashita ◽  
Tetsunori Ishikawa ◽  
Kinta Hatakeyama ◽  
Yoshisato Shibata ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Stent Thrombosis ◽  
De Novo ◽  
Drug Eluting Stent ◽  
Drug Eluting

HORIZONS and Drug-eluting Stent Usage in Acute Myocardial Infarction

2009 ◽  
Vol 4 (1) ◽  
pp. 53
Author(s):  
Gaku Nakazawa ◽  
Masataka Nakano ◽  
Marc Vorpahl ◽  
Frank Kolodgie ◽  
Renu Virmani ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Stent Thrombosis ◽  
Bare Metal Stents ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Metal Stents ◽  
St Segment Elevation ◽  
Risk Of Death ◽  
Drug Eluting

Myocardial infarction (MI) is one of the few clinical presentations whereby percutaneous coronary intervention reduces the risk of death compared with medical therapy alone. However, treatment with drug-eluting stents (DES) – so-called ‘off-label’ use for patients with ST-segment-elevation MI (STEMI) – raises safety concerns with respect to the morbidity and mortality attributed to late stent thrombosis (LST). Pathology data clearly indicate delayed healing as the primary substrate in all cases of DES-related LST, where differences in lesion morphology invariably show a greater prevalence of uncovered struts, accumulated fibrin and inflammation in ruptures relative to stable plaques. The prolonged risk of LST appears to persist up to at least four years after DES implantation. Results from the recently published Harmonising Outcomes with Revascularisation and Stents – Acute Myocardial Infarction (HORIZONS-AMI) trial of 3,006 prospective patients presenting with STEMI, randomised to paclitaxel-eluting (PES) or identical bare-metal stents (BMS), show similar 12-month death and stent thrombosis rates. Despite a significant reduction in ischaemia-driven target lesion revascularisation, a sub-study analysis showed a greater incidence of malapposition in patients receiving PES. Along these same lines, other registry studies point towards inconsistencies in advocating the use of DES for AMI. Considering that arterial healing in response to DES is delayed for periods longer than one year, long-term follow-up beyond this point is required to confirm the results of the HORIZONS trial. However, despite the final outcome, the results may remain disputable since the trial may not have been sufficiently powered to address the relative risks of LST or mortality. Clearly, there remains a need for larger randomised controlled studies before the broader use of this technology in AMI patients is settled.

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