In-stent restenosis and thrombosis 41 months after drug-eluting stent implantation |
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Authors: | Jamshidi Peiman Toggweiler Stefan Erne Paul |
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Affiliation: | aDivision of Cardiology, Kantonsspital Luzern, CH-6000 Luzern 16, Switzerland |
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Abstract: | Evidence indicates that very late stent thrombosis (> 1 year) occurs more frequently in drug-eluting stents than in bare metal stents after discontinuation of clopidogrel. We present a case of an 83 year old man with an LAD in-stent thrombosis 41 months after stenting with a sirolimus-eluting stent in whom clopidogrel was discontinued after 6 months based on these days' guidelines. In-stent thrombus was aspirated and intracoronary ultrasound (ICUS) showed significant in-stent restenosis which had narrowed the minimal lumen diameter by 1 mm. The lesion was stented with a bare metal stent. The patient was discharged after recovery and had no recurrence of stent thrombosis in one month follow-up. We recommended indefinite dual antiplatelet therapy with aspirin and clopidogrel. |
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Keywords: | Very late stent thrombosis ICUS Coronary angiography Stenting |
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