Seeing Is Believing: Optical Computed Tomography (OCT) and Histologic Analysis To Define Pathophysiology Of “Very”, Very Late Stent Thrombosis Occurring More Than 7 Years After Drug Eluting Stent Implantation

Abstract

Case Presentation 58-year-old male with prior non-ST elevation MI with PCI performed using a sirolimus eluting stent placed in a large OM1 branch 86 months prior presented with five hours chest pain similar to prior MI \u3e7 years earlier. Additional history of hypertension, hyperlipidemia, non-compliance with antiplatelet therapy and active tobacco abuse at time of presentation. Patient reported self-discontinuation of medications (aspirin (time unknown), statin, beta blocker) and resumed smoking. Clopidogrel was discontinued by his primary physician 97 days prior to presentation Initial electrocardiogram revealed a lateral ST elevation MI and the patient was taken to the cardiac catheterization lab for urgent coronary angiography