Korean Circ J.  2007 Aug;37(8):385-387. 10.4070/kcj.2007.37.8.385.

Very Late Stent Thrombosis Related to Fracture of a Sirolimus-Eluting Stent

• Nam CW
• Kim KB
• Chung IS

• KMID: 2029067
• DOI: http://doi.org/10.4070/kcj.2007.37.8.385

Abstract

Although late stent thrombosis is a very rare complication after a drug-eluting stent implantation, this could induce significant sequelae. Several mechanisms for very late stent thrombosis have been suggested. We experienced a new possible mechanism of very late stent thrombosis after the implantation of a sirolimus-eluting stent. A sirolimus-eluting stent fracture might induce mechanical injury of the endothelium and then thrombotic occlusion at 24 months after the stent procedure.

Keyword

Thrombosis; Stents; Sirolimus

MeSH Terms

Drug-Eluting Stents
Endothelium
Sirolimus
Stents*
Thrombosis*
Sirolimus

Figure

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  Fig. 1 Angiographic images of the right coronary artery (RCA). A: The initial angiogram showed two focal stenotic lesions at the proximal and mid RCA. B: The follow-up angiogram at 8 months showed a patent stents with minimal luminal narrowing. C: Thrombotic total occlusion in the mid RCA was noted, which was the previous sirolimus-eluting stent implanted site. D: After ballooning, there was minimal residual stenosis. E: The 2nd follow-up angiogram at 6 months showed that the previous ballooning site was patent.

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  Fig. 2 Top: Longitudinal IVUS reconstruction of the RCA; the white vertical square corresponds to the point of stent fracture. Bottom: A, B, and C are cross-sectional images corresponding the positions a, b and c on the longitudinal reconstruction. A and C; There are stent struts visible with minimal intimal hyperplasia. B; There is mild concentric plaque with loss of the stent strut, which indicates stent fracture.

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