Discontinuation of antiplatelet medications has been strongly associated with coronary stent thrombosis. The first reported cases have been documented at 6 h to 6 weeks after stent implantation. This article presents a case of very late stent thrombosis 24 months after sirolimus eluting stent implantation and 18 months after clopidogrel discontinuation, despite aspirin continuation, and argues in favor of prolonging dual antiplatelet medication including clopidogrel in this setting, at least until data from randomized trials address this important issue.

Keywords:
Stent, Thrombosis
1.
Jeremias A, Sylvia B, Bridges J, Kirtane AJ, Bigelow B, Pinto DS, Kalon KL, Cohen DJ, Garcia LA, Cutlip DE, Carrozza JP: Stent thrombosis after successful sirolimus-eluting stent implantation. Circulation 2004;109:1930–1932.
2.
Kerner A, Gruberg L, Kapeliovich M, Grenadier E: Late stent thrombosis after implantation of a sirolimus-eluting stent. Catheter Cardiovasc Interv 2003;60:505–508.
3.
McFadden EP, Stabile E, Regar E, Cheneau E, Ong AT, Kinnaird T, Suddath WO, Weissman NJ, Torguson R, Kent KM, Pichard AD, Satler LF, Waksman R, Serruys PW: Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy. Lancet 2004;364:1519–1521.
© 2007 S. Karger AG, Basel
2006
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