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Very late stent thrombosis (VLST; > 1 year) is a rare but fatal complication due to acute vessel closure. Several factors, including procedure, lesion and patient discontinuation of antiplatelet therapy, are most closely related to its occurrence [1]. Furthermore, neoatherosclerotic plaque rupture is now acknowledged as a potential contributing factor [2]. Although similar rates of early and late stent thrombosis were observed between drug-eluting stent (DES) and bare metal stent (BMS) [3]. Very late stent thrombosis occurs with higher frequency in DES [4]. However, it is even rarer to have a simultaneous two-vessel very late stent thrombosis with a sirolimus-eluting stent (SES), and studies on the pathogeny are lacking.  We report the case of a patient presenting with ST-segment-elevation myocardial infarction (STEMI) and cardiogenic shock who experienced simultaneous VLST in two vessels which occurred 40 months after sirolimus-eluting stent implantation.

postępy w kardiologii interwencyjnej

Acute two-vessel occlusion due to simultaneous very late stent thrombosis following sirolimus-eluting stent implantation: a case report and review of the literature