Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

The lack of endothelization after drug-eluting stent implantation as a cause of fatal late stent thrombosis

  • 183 Accesses

  • 6 Citations


The authors present a fatal case of late thrombosis of paclitaxel-eluting stent implanted in the left main stem occurring 6 months after the procedure and 3 weeks after the cessation of clopidogrel. An autopsy has shown the lack of endothelization of deployed stent.

This is a preview of subscription content, log in to check access.

We’re sorry, something doesn't seem to be working properly.

Please try refreshing the page. If that doesn't work, please contact support so we can address the problem.

Fig. 1
Fig. 2


  1. 1.

    Sousa JE, Costa MA, Abizaid AC et al (2001) Sustained supression of neointimal proliferation bz sirolimus-eluting stents. One-year angiographic and intravascular ultrasound follow-up. Circulation 104:2007–2011

  2. 2.

    Morice MC, Serruys PW, Sousa JE et al (2002) A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med 346:1773–1780

  3. 3.

    Moses JW, Leon MB, Popma JJ et al, SIRIUS Investigators (2003) Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 349:1315–1323

  4. 4.

    Schofer J, Schluter M, Gershlick AH et al, E-SIRIUS Investigators (2003) Sirolimus-eluting stents for treatment of patients with long atherosclerotic lesions in small coronary arteries: double-blind, randomized controlled trial (E-SIRIUS). Lancet 362:1093–1099

  5. 5.

    Hong MK, Mintz GS, Lee CW et al, Asian Paclitaxel-Eluting Stent Clinical Trial Investigators (2003) Paclitaxel coating reduces in-stent intimal hyperplasia in human coronary arteries: a serial volumetric intravascular ultrasound analysis from the Asian Paclitaxel-Eluting Stent Clinical Trial (ASPECT). Circulation 107:517–520

  6. 6.

    Grube E, Silber S, Hauptmann KE et al (2003) TAXUS I: six- and twelve-month results from a randomized, double-blind trial on a slow-release paclitaxel-eluting stent for de novo coronary lesions. Circulation 107:38–42

  7. 7.

    Stone GW, Ellis SG, Cox DA et al, TAXUS-IV Investigators (2004) A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease. N Engl J Med 350:221–231

  8. 8.

    Pfisterer ME, Kaiser CA, Bader F et al (2006) Late clinical events related to late stent thrombosis after stopping clopidogrel: prospective randomized comparison between dru-eluting versus bare-metal stenting. Program and abstracts from the American College of Cardiology 55th Annual Scientific Session, March 11–14, 2006, Atlanta, Georgia. Abstract 422–11

  9. 9.

    Iakovou I, Schnidt T, Bonizzoni E et al (2005) Incidence, predictors and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA 293:2126–2130

  10. 10.

    Kuchulakanti PK, Chu WW, Torguson R et al (2006) Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents. Circulation 113:1108–1113

  11. 11.

    Takano M, Ohba T, Inami S et al (2006) Angioscopic differences in neointimal overage and in persistence of thrombus between sirolimus-eluting stents and bare metal stents after a 6-month implantation. EHJ 27:2189–2195

  12. 12.

    Virmani R, Guagliumi G, Farb A et al (2004) Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent: should we be cautious? Circulation 109:701–705

  13. 13.

    Ong A, McFadden E, Regar E et al (2005) Late angiographic stent thrombosis (LAST) events with drug-eluting stents. J Am Coll Cardiol 45:2088–2092

  14. 14.

    Urban P, Gershlick A, Guagliumi G et al (2006) E-Cypher investigators. Safety of coronary sirolimus-eluting stents in daily clinical practice: one-year follow-up of the e-Cypher registry. Circulation 21:1434–1441

  15. 15.

    Moreno R, Fernandez C, Hernandez R et al (2005) Drug-eluting stent thrombosis: results from a pooled analysis including 10 randomized studies. J Am Coll Cardiol 45:954–959

  16. 16.

    Joner M, Finn AV, Farb A et al (2006) Pathology of drug-eluting stents in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 48:193–202

  17. 17.

    Laarman GJ, Suttorp MJ, Dirksen MT et al (2006) Paclitaxel-eluting versus uncoated stents in primary percutaneous coronary intervention. N Engl J Med 355:1105–1113

  18. 18.

    Spaulding C, Henry P, Teiger E et al (2006) Sirolimus-eluting versus uncoated stents in acute myocardial infarction. N Engl J Med 355:1093–1104

  19. 19.

    Valgimigli M, van Mieghem CAG, Ong ATL et al (2005) Short- and long-term clinical outcome after drug-eluting stent implantation for the percutaneous treatment of left main coronary artery disease. Insights from the rapamycin-eluting and taxus stent evaluated at Rotterdam cardiology hospital registries (RESEARCH and T-SEARCH). Circulation 111:1383–1389

Download references

Author information

Correspondence to Jozef Jakabčin or Pavel Červinka.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Jakabčin, J., Bystroň, M., Špaček, R. et al. The lack of endothelization after drug-eluting stent implantation as a cause of fatal late stent thrombosis. J Thromb Thrombolysis 26, 154–158 (2008).

Download citation


  • Late stent thrombosis
  • Paclitaxel-eluting stent
  • Coronary intervention
  • Drug-eluting stent
  • Acute myocardial infarction
  • Percutaneous coronary interventions of left main stem
  • Dual antiplatelet treatment