Skip to main content
SpringerLink
Log in

Very late stent thrombosis occurring simultaneously in sirolimus-eluting stents and bare-metal stent in three different coronary vessels

  • Case Report
  • Published:
Cardiovascular Intervention and Therapeutics Aims and scope Submit manuscript

Abstract

A 36-year-old male was diagnosed with acute inferior myocardial infarction (MI). Emergent coronary angiography (CAG) revealed an occlusive lesion in the distal segment of the right coronary artery (RCA). The proximal and distal sites of the lesion were treated with a bare-metal stent (BMS) and a sirolimus-eluting stent (SES), respectively. Nine days later, he underwent elective percutaneous coronary intervention (PCI). Two SESs were implanted for the stenotic lesion in the left anterior descending artery (LAD), in addition to one SES for the mid-stenotic lesion in the left circumflex artery (LCX). Nine months after PCI, follow-up CAG revealed no restenosis at any stent-implanted site. Two years and 4 months after PCI, he was admitted to our hospital because of acute anterior MI. Emergent CAG revealed total thrombotic occlusion in the in-stent proximal site of LAD. Moreover, thrombotic lesions were also observed in in-stent sites: in both BMS of RCA and SES of LCX. He underwent intracoronary aspiration thrombectomy and plain old balloon angioplasty for LAD using intra-aortic balloon pumping. PCI for the thrombotic lesions in RCA and LCX was not performed. Seventeen days after the stent thrombosis, CAG revealed the complete disappearance of thrombi in LAD, LCX, and RCA.

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

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Kammler J, Hofmann R, Steinwender C, Kypta A, Leisch F. Simultaneous angiographic late stent thrombosis in two different coronary vessels after withdrawal of the combined anti-platelet therapy. Clin Res Cardiol. 2006;95:560–4.

    Article  PubMed  Google Scholar 

  2. Arora N, Aggarwal K. Simultaneous late stent thrombosis of drug-eluting stents causing acute anterior and inferior myocardial infarction. J Invasive Cardiol. 2008;20(1):E14–7.

    Google Scholar 

  3. Vaknin-Assa H, Iakobishvili Z, Kornowski R. Very late stent thrombosis : simultaneous two-arterial occlusions. Cardiovasc Revasc Med. 2008;9:281–3.

    Article  PubMed  Google Scholar 

  4. Quercia JH, Kane BG, Kane KE. Simultaneous very late angiographic stent thrombosis of 2 drug-eluting stents: a case report. Am J Emerg Med. 2009;27(1):131.e5–8.

    Google Scholar 

  5. Wenaweser P, Daemen J, Zwahlen M, Domburg R, Juni P, Windecker S, et al. Incidence and correlates of drug-eluting stent thrombosis in routine clinical practice. J Am Coll Cardiol. 2008;52:1134–40.

    Article  CAS  PubMed  Google Scholar 

  6. Doyle B, Charanjit S, Crochan J, Ryan J, Heather J, David R, et al. Outcome of stent thrombosis and restenosis during extended follow-up of patients treated with bare-metal coronary stents. Circulation. 2007;116:2391–8.

    Article  PubMed  Google Scholar 

  7. Iakovou I, Schmidt T, Bonizzoni E, Ge L, Sangiorgi G, Colombo A, et al. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA. 2005;293:2126–30.

    Article  CAS  PubMed  Google Scholar 

  8. Pramod K, William W, Torguson R, Ohlmann P, Rha S, Waksman R, et al. Correlates and long-term outcome of angiographically proven stent thrombosis with sirolimus- and paclitaxel-eluting stents. Circulation. 2006;113:1108–13.

    Article  Google Scholar 

  9. Jochem W, Antonius A, Carla Z, Johannes C, Maarten-Jan S, Benno J, et al. Predictors of coronary stent thrombosis. The Dutch stent thrombosis registry. J Am Coll Cardiol. 2009;53:1399–409.

    Article  Google Scholar 

  10. Urban P, Anthony H, Guagliumi G, Guyon P, Lotan C, Stoll H, et al. Safety of coronary sirolimus-eluting stents in daily clinical practice. One-year follow-up of the e-Cypher Registry. Circulation. 2006;113:1434–41.

    Article  CAS  PubMed  Google Scholar 

  11. Cook S, Wenaweser P, Togni M, Billinger M, Morger C, Windecker S, et al. Incomplete stent apposition and very late stent thrombosis after drug-eluting stent implantation. Circulation. 2007;115:2426–34.

    Article  CAS  PubMed  Google Scholar 

  12. Fujii K, Carlier S, Mintz G, Yang Y, Moussa I, Leon M, et al. Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation. J Am Coll Cardiol. 2005;45:995–8.

    Article  CAS  PubMed  Google Scholar 

  13. Ako J, Morino Y, Honda Y, Hassan A, Sonoda S, Fitzgerald P, et al. Late incomplete stent apposition after sirolimus-eluting stent implantation. J Am Coll Cardiol. 2005;46:1002–5.

    Article  CAS  PubMed  Google Scholar 

  14. Katsumi I, Kazuaki M, Masakiyo N, et al. Medial necrosis due to sirolimus-eluting stent implantation in human coronary artery. J Cardiol. 2008;51:60–4.

    Article  Google Scholar 

  15. Hong M, Mintz G, Lee C, Kim Y, Lee S, Park S, et al. Incidence, mechanism, predictors, and long-term prognosis of late stent malapposition after bare-metal stent implantation. Circulation. 2004;109:881–6.

    Article  PubMed  Google Scholar 

  16. Masaki A, Junichi K, Masaaki U, Takakazu M, Tetsuya W, Toshinari O, et al. Serial angioscopic evidence of incomplete neointimal coverage after sirolimus-eluting stent implantation. Comparison with bare-metal stent. Circulation. 2007;116:910–6.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Cardiology, Fujinomiya City General Hospital, 3-1 Nishiki-cho, Fujinomiya, Sizuoka, 418-0076, Japan

    Yoshitaka Kawaguchi, Junpei Katayama, Azumi Kumazawa, Hirofumi Sugiyama, Tomoyuki Watanabe & Nobuyuki Wakahara

Authors
  1. Yoshitaka Kawaguchi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Junpei Katayama
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Azumi Kumazawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hirofumi Sugiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tomoyuki Watanabe
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nobuyuki Wakahara
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yoshitaka Kawaguchi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kawaguchi, Y., Katayama, J., Kumazawa, A. et al. Very late stent thrombosis occurring simultaneously in sirolimus-eluting stents and bare-metal stent in three different coronary vessels. Cardiovasc Interv and Ther 26, 64–69 (2011). https://doi.org/10.1007/s12928-010-0028-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12928-010-0028-x

Keywords

Search

Navigation