A Case of Very Late Bare-Metal Coronary Stent Thrombosis Two Weeks after Aspirin Discontinuation, Histopathologic Thrombus Findings and Clinical Considerations

There have been consistent evidences that atherosclerotic changes occur inside bare metal stents (BMS) during an extended period after implantation. This report describes the histopathologic features of aspirated material harvested from a patient with definite very late stent thrombosis of a BMS implanted 18 years prior. The patient presented with a recurrent anterior acute myocardial infarction 14 day after aspirin discontinuation. We suggest that vulnerable neointimal tissue inside the stent struts of BMS may be one potential trigger of thrombosis when the protection of aspirin treatment is ceased.