Very late stent thrombosis and neointimal plaque rupture after implantation of sirolimus-eluting stents: observations with angiography, IVUS and OCT
ABSTRACT Drug-eluting stent (DES) dramatically reduces the incidence of restenosis and rates of target lesion revascularization. Although
several reports suggest that very late stent thrombosis could occur in patients after DES implantation, neointimal plaque
rupture may be uncommon in the patients treated with DES compared with bare-metal stent. It is unclear that the reason why
the patient in acute coronary syndrome (ACS) treated with DES has a high frequency of very late stent thrombosis and pathophysiological
mechanisms of neointimal plaque rupture after DES implantation. We report a case of very late stent thrombosis with the findings
of neontimal plaque rupture as well as incomplete stent apposition 4years after sirolimus-eluting stent implantation in ACS.
KeywordsSirolimus-eluting stent (SES)–Intravascular ultrasound (IVUS)–Very late stent thrombosis–Incomplete stent apposition (ISA)–Neointimal plaque rupture