TY - JOUR AU - Murai, Kota AU - Sakata, Kenji AU - Mabuchi, Tomohito AU - Yamaguchi, Masato AU - Mori, Masayuki AU - Hayashi, Kenshi AU - Kawashiri, Masa-Aki PY - 2018 TI - Very late bare metal stent thrombosis in the setting of discontinuation of optimal medical therapy for 2 years JF - Cardiovascular Diagnosis and Therapy; Vol 8, No 2 (April 17, 2018): Cardiovascular Diagnosis and Therapy Y2 - 2018 KW - N2 - A 52-year-old man was admitted to our hospital because of acute anteroseptal myocardial infarction. After a bare metal stent (BMS) was implanted in the left anterior descending artery (LAD), aspirin, clopidogrel, statin, angiotensin II receptor blocker, and β blocker were prescribed. 6 years later, however, the patient stopped taking all medication by himself. Further 2 years later, the patient was admitted to our hospital again with chest pain, and emergent coronary angiography showed the total occlusion of the LAD at the site where the previous stent was deployed. Optical coherent tomography (OCT) showed lipid rich neointima with thin cap, suggesting neoatherosclerosis at the proximal to the occlusive site. OCT also showed white thrombus formation around at the occlusive site. Intravascular ultrasound (IVUS) showed the ruptured cavity within the stent at the occlusive site. These findings suggest that the neoatherosclerosis had progressed and ruptured within BMS for 2 years. We would suggest continuation of not only an antiplatelet agent but other optimal medical therapy to prevent the substantial neoatherosclerotic burden and occurrence of late phase stent thrombosis even in BMS. UR - https://cdt.amegroups.org/article/view/18964