PMID- 30279857
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1878-5409 (Print)
IS  - 1878-5409 (Electronic)
IS  - 1878-5409 (Linking)
VI  - 17
IP  - 2
DP  - 2018 Feb
TI  - A unique case of ST-elevation myocardial infarction related to very late stent 
      thrombosis.
PG  - 63-67
LID - 10.1016/j.jccase.2017.09.008 [doi]
AB  - A 67-year-old man was transferred to our hospital because of anterior ST 
      elevation myocardial infarction (STEMI). He had a history of a sirolimus-eluting 
      stent implantation from the left main to the left anterior descending coronary 
      artery (LAD) 9 years before and had undergone laparoscopic prostatectomy 8 days 
      before in the setting of discontinuation of dual antiplatelet therapy. Emergent 
      coronary angiography showed total occlusion in the distal LAD that was 
      successfully treated by aspiration alone. Optical coherence tomography (OCT) 
      showed no vulnerable lesion from the occluded lesion to the proximal LAD. OCT 
      demonstrated that the thrombus attached to floating struts at the left main 
      bifurcation and non-apposed struts at the left coronary ostium partly protruding 
      to aorta, while the other struts were covered and well-apposed. Based on OCT 
      findings, this case of STEMI was thought to be caused by distal embolism of a 
      thrombus that formed at the stent site before it evolved into total occlusion. 
      <Learning objective: We demonstrated how optical coherence tomography can be 
      essential in revealing the underlying pathology. The patient showed an unusual 
      manifestation of ST-elevation myocardial infarction caused by distal embolism of 
      a thrombus that formed at the sirolimus-eluting stent due to dual antiplatelet 
      therapy discontinuation during perioperative period. Optical coherence tomography 
      revealed very late stent thrombosis at the left coronary ostium and could 
      elucidate the underlying mechanism.>.
FAU - Takahashi, Tatsunori
AU  - Takahashi T
AD  - Department of Cardiology, Ehime Prefectural Central Hospital, Ehime, Japan.
FAU - Okayama, Hideki
AU  - Okayama H
AD  - Department of Cardiology, Ehime Prefectural Central Hospital, Ehime, Japan.
FAU - Hiasa, Go
AU  - Hiasa G
AD  - Department of Cardiology, Ehime Prefectural Central Hospital, Ehime, Japan.
FAU - Kazatani, Yukio
AU  - Kazatani Y
AD  - Department of Cardiology, Ehime Prefectural Central Hospital, Ehime, Japan.
LA  - eng
PT  - Case Reports
DEP - 20171013
PL  - Japan
TA  - J Cardiol Cases
JT  - Journal of cardiology cases
JID - 101549579
PMC - PMC6149559
OTO - NOTNLM
OT  - Drug-eluting stent
OT  - Dual antiplatelet therapy
OT  - Optical coherence tomography
EDAT- 2018/10/04 06:00
MHDA- 2018/10/04 06:01
PMCR- 2017/10/13
CRDT- 2018/10/04 06:00
PHST- 2017/07/07 00:00 [received]
PHST- 2017/09/21 00:00 [revised]
PHST- 2017/09/24 00:00 [accepted]
PHST- 2018/10/04 06:00 [entrez]
PHST- 2018/10/04 06:00 [pubmed]
PHST- 2018/10/04 06:01 [medline]
PHST- 2017/10/13 00:00 [pmc-release]
AID - S1878-5409(17)30100-7 [pii]
AID - 10.1016/j.jccase.2017.09.008 [doi]
PST - epublish
SO  - J Cardiol Cases. 2017 Oct 13;17(2):63-67. doi: 10.1016/j.jccase.2017.09.008. 
      eCollection 2018 Feb.