Extremely late (7 years) paclitaxel-eluting stent thrombosis

In the last decade percutaneous coronary interventions (PCI) with drug-eluting stents (DES) have reduced significantly restenosis rates. Therefore, DES have become the standard of care and most widely used for the treatment of atherosclerotic coronary artery disease [1]. Very late stent thrombosis (VLST), defined as stent thrombosis at the site of PCI 1 year after stent deployment by the Academic Research Consortium, has been recognized as a DES implantation complication [2]. It has been related to delayed arterial healing and positive vessel remodelling, leading to late-acquired stent malapposition and incomplete reendothelization [3, 4]. Second-generation DES are associated with lower rates of stent thrombosis [5], but VLST up to 5 years has been widely described in firstgeneration DES (sirolimus and paclitaxel DES) [6–8], and even extremely cases (7–8 years) have been communicated with sirolimus DES (SES) implantation after antiplatelet therapy cessation [9, 10]. Nevertheless, extremely VLST related to paclitaxel DES (PES), even on aspirin treatment, has not been previously described. This report presents a case of definite and extremely VLST 7 years after a PES deployment at culprit lesion for acute myocardial infarction (AMI). Case report