[Clinical features of late stent thrombosis after successful sirolimus-eluting stent implantation].

Objective: To analyze the potential risk factors for patients developing late stent thrombosis (LST) after successful sirolimus-eluting stents (SES) implantation.

Methods: The clinical, angiographic, procedural as well as antiplatelet therapy data were retrospectively analyzed in 8 patients with LST after successful SES implantation.

Results: The patient's mean age was (51 +/- 10) years old and indication for SESs was mostly acute coronary syndrome with multiple risk factors of cardiovascular diseases. There was 1 chronic heart failure patient and renal function was normal in all patients. Multivessel diseases and complex coronary lesions including total occlusion lesions, bifurcation lesions and long lesions were seen in these patients. The mean release pressure of stents was (11.60 +/- 1.65) atm and with no high-pressure dilation after the procedure. The median time of dual antiplatelet therapy was (157.5 +/- 41.7) days. The mean duration from SESs implantation to thrombosis was (450.3 +/- 344.7) days. LST developed in 2 patients with active dual antiplatelet therapy, 1 patient at 7 days and 5 patients at 6 months after clopidogrel withdraw, 5 patients presented nonfatal acute myocardial infarction, 1 patient died of acute myocardial infarction after coronary artery bypass grafting. Five patients were successfully treated with second SESs implantations and another one was treated medically.

Conclusions: LST could be safe and effective treated with re-SESs. The development of LST after successful SESs implantation were probably associated with the following factors: (1) acute coronary syndrome with multiple risk factors of cardiovascular diseases and multivessel diseases with complex coronary lesions. (2) Low-pressure deployment without high-pressure dilation after the release. (3) Dual antiplatelet therapy withdraw.