Very Late Stent Thrombosis after Sole Stent-Assisted Coiling at the Paraclinoid Giant Aneurysm : Could Prophylactic Antiplatelet Therapy Be Ceased at the Only 1 Year after Procedure?

Stent thrombosis is a major limitation of stent-assisted coiling, which is an effective method for treating wide-necked aneurysms. Although early in-stent thrombosis has been reported, very late stent thrombosis (VLST) (>1 year) has not been reported following implantation of a single self-expandable stent designed for coiling. Herein, the authors present a case of VLST that occurred 14 months after single stent implantation in a large paraclinoid aneurysm with an ultra-wide neck involving the parent artery circumferentially. This case indicates the need for establishing guidelines regarding the optimal duration of prophylactic antiplatelet therapy following stent-assisted coiling, which remains undefined in the neuroendovascular field.

A Case of Extremely Very Late Stent Thrombosis 8 Years after Implantation of Drug-Eluting Stent Observed by Intravascular Ultrasound

Drug-eluting stents (DES) are now widely used for patients with coronary artery disease undergoing percutaneous coronary interventions. The current major agenda for using DES is very late stent thrombosis (VLST) that occurs beyond 1 year after DES implantation. Although VLST is rare, it is a serious complication that can result in sudden death or myocardial infarction. Until now, there have been only a few case reports of VLST within 7 years. We report a case of a 78-year-old man who presented with an ST segment elevation myocardial infarction due to extremely very late stent thrombosis resulting from a mal-apposed stent and delayed neointimal coverage that occurred 8 years after stent implantation after the cessation of antiplatelet agents for 10 days.