Simultaneous very late stent thrombosis in multiple coronary arteries

Seshasayee Narasimhan, Nassim Rostane Krim, Gary Silverman, Ernest Scott Monrad

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


We report 2 noteworthy cases of very late stent thrombosis presenting as ST-segmentelevation myocardial infarction, with vastly different manifestations. Both patients were women who had histories of multivessel percutaneous coronary intervention with firstgeneration sirolimus-eluting stents, in 2005 and 2006. On the more recent occasions reported here, one underwent successful multivessel primary percutaneous coronary intervention, while the other underwent successful multivessel "plain old balloon angioplasty." Both were discharged from the hospital with advice to stop smoking and to follow a lifelong regimen of aspirin and clopidogrel. On the basis of these two cases and our review of the current literature, we ask whether it is now prudent to recommend lifelong dual antiplatelet therapy after drug-eluting stent deployment. Moreover, in order to account for cases of stent thrombosis that occur ≥5 years after drug-eluting stent implantation, should we perhaps suggest the addition of "extremely late stent thrombosis" to the existing Academic Research Consortium classification?.

Original languageEnglish (US)
Pages (from-to)630-634
Number of pages5
JournalTexas Heart Institute Journal
Issue number5
StatePublished - Oct 1 2012


  • Aspirin
  • Clopidogrel
  • Coronary restenosis/etiology
  • Coronary thrombosis/etiology
  • Drug delivery systems/adverse effects
  • Immunosuppressive agents
  • Paclitaxel
  • Platelet aggregation inhibitors/therapeutic use
  • Sirolimus/therapeutic use
  • Stent thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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