Thrombosis late after implantation is an infrequent but increasingly recognized complication following revascularization with drug-eluting stents (DES). The window of vulnerability for this complication with DES remains undefined. Intermediate-term follow up from pivotal trials and registries suggests continuous separation of event curves out to at least 3 years. We briefly review the evolving body of literature on DES thrombosis and report a case of very late thrombosis 53 months after implantation of a sirolimus-eluting stent. The event occurred despite chronic aspirin monotherapy and represents the longest latency from implantation to thrombosis described in the literature for a DES.

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