Cassin Matteo, De Biasio Marzia, Macor Franco, Burelli Claudio, Vendrametto Fauzia, Driussi Mauro, Nicolosi Gian Luigi
Division of Cardiology-A.R.C., S. Maria degli Angeli Hospital, Pordenone, Italy.
J Cardiovasc Med (Hagerstown). 2007 Apr;8(4):284-8. doi: 10.2459/01.JCM.0000263500.39024.3a.
Drug-eluting stent (DES) implantation has reduced angiographic and clinical restenosis that actually develops in less than 10% of treated patients. DESs also tend to delay the endothelialisation process increasing the risk of stent thrombosis. Subacute stent thrombosis may complicate long-term success of coronary angioplasty; it is a sudden event and usually causes acute myocardial infarction or sudden cardiac death. Patients undergoing DES implantation should be treated with dual antiplatelet therapy for at least 3-6 months. We describe two cases presenting with ST-elevation acute myocardial infarction due to stent thrombosis that occurred late after deployment of a paclitaxel-eluting stent, after discontinuation of antiplatelet therapy. It is important, for clinical cardiologists and general practitioners, to know the potential risk of late thrombosis of DES patients and, consequently, the implications regarding management of antiplatelet therapy.
药物洗脱支架（DES）植入术已减少了血管造影显示的以及实际发生在不到10%接受治疗患者中的临床再狭窄。DES还往往会延迟内皮化过程，增加支架血栓形成的风险。亚急性支架血栓形成可能会使冠状动脉血管成形术的长期成功复杂化；这是一种突发情况，通常会导致急性心肌梗死或心源性猝死。接受DES植入术的患者应接受至少3至6个月的双联抗血小板治疗。我们描述了两例因停用抗血小板治疗后，在紫杉醇洗脱支架置入术后晚期发生支架血栓形成而出现ST段抬高型急性心肌梗死的病例。对于临床心脏病专家和全科医生而言，了解DES患者晚期血栓形成的潜在风险以及因此对抗血小板治疗管理的影响非常重要。
