Late thrombosis in drug-eluting coronary stents after discontinuation of antiplatelet therapy

Lancet. 2004 Oct 23-29;364(9444):1519-21. doi: 10.1016/S0140-6736(04)17275-9.


Although the safety profiles of coronary stents eluting sirolimus or paclitaxel do not seem to differ from those of bare metal stents in the short-to-medium term, concern has arisen about the potential for late stent thromboses related to delayed endothelialisation of the stent struts. We report four cases of angiographically-confirmed stent thrombosis that occurred late after elective implantation of polymer-based paxlitaxel-eluting (343 and 442 days) or sirolimus-eluting (335 and 375 days) stents, and resulted in myocardial infarction. All cases arose soon after antiplatelet therapy was interrupted. If confirmed in systematic long-term follow-up studies, our findings have potentially serious clinical implications.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioplasty, Balloon, Coronary
  • Coronary Disease / therapy
  • Coronary Thrombosis / etiology*
  • Coronary Vessels
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / etiology
  • Paclitaxel / administration & dosage*
  • Platelet Aggregation Inhibitors / therapeutic use*
  • Sirolimus / administration & dosage*
  • Stents / adverse effects*


  • Platelet Aggregation Inhibitors
  • Paclitaxel
  • Sirolimus