Acute thrombosis of a mesenteric artery drug-eluting stent following clopidogrel cessation

LEARNING OBJECTIVE: To describe thrombosis of sirolimus-coated mesenteric arterial stents following cessation of clopidogrel therapy. BACKGROUND: Cardiac drug-eluting stent thrombosis following cessation of antiplatelet therapy with clopidogrel has been associated with increased mortality. The application of such stents in the mesenteric arterial system and the subsequent need for clopidogrel therapy has not been studied. This is the first case report of acute thrombosis of a drug-coated stent in the mesenteric circulation. CLINICAL FINDINGS: Acute mesenteric ischemia secondary to thrombosis of a mesenteric arterial stent following clopidogrel cessation is described. CONCLUSION: Drug-eluting stents represent an option for mesenteric revascularization in the surgically complicated abdomen. As in the setting of cardiac stenting, acute thrombosis of these devices following cessation of clopidogrel therapy is a concern. Indefinite clopidogrel therapy following deployment of drug-coated stents should be considered.