'Very' very late stent thrombosis
: Acute myocardial infarction from drug-eluting stent thrombosis more than 5 years after implantation.
Comparison of Short and Long Term Cardiac Mortality in Early Versus Late Stent Thrombosis
(from Pooled PROTECT Trials).
We did not observe any acute, subacute, or late stent thrombosis
in this study.
Even second-generation cobalt-chromium EES (CoCr-EES), possessing greater strut coverage with lower incidence of late/very late stent thrombosis
than SES and PES in human autopsy analysis, findings showed that the frequency of NA in CoCr-EES was not statistically different when compared with first-generation devices .
(7) demonstrated that patients with very late stent thrombosis
showed positive arterial remodeling with a high incidence of stent malapposition.
"The higher incidence of late stent thrombosis
in the Z-ES group was driven by an increased incidence of definite stent thrombosis."
This delay of endothelial growth is induced by an inappropriate long-term drug release and can lead to late stent thrombosis
An independent analysis also confirmed XIENCE V's low late stent thrombosis
rate of 0.7 percent.
"Increased late stent thrombosis
risk and the long term dual anti-platelet medication which are associated with the majority of current drug eluting stents is a concern in treating our patients today," said Primary Investigator of the PIONEER Study Peter Smits, M.D., head of Intervention Cardiology at the Maasstad Hospital, Rotterdam, The Netherlands.
The issue of late stent thrombosis
after DES usage has influenced stent usage patterns.