Very late stent thrombosis after sirolimus-eluting stent implantation observed using optical coherence tomography and coronary angioscopy.

Sirolimus-eluting stents (SES) are now commonly used for percutaneous coronary intervention (PCI) because they dramatically reduce the rates of restenosis and target lesion revascularization, even in small vessels and long lesions as compared with bare-metal stent. The unresolved issue about SES use is the possibility of late stent thrombosis. Late stent thrombosis is a very rare, but serious complication that may result in acute myocardial infarction or sudden cardiac death. However, the mechanism of late stent thrombosis with SES has not been established. We report a patient with very late stent thrombosis 37 months after SES implantation who underwent optical coherence tomography and coronary angioscopy.