Two cases of very late bare-metal stent thrombosis and literature review.

BACKGROUND: Bare metal stents (BMS) are commonly used in the treatment of coronary artery disease. Very late stent thrombosis (VLST) is a quite rare clinical entity. However, it is a serious complication that often results myocardial infarction or death. Since the stent endothelialization is considered to be completed within 4 weeks after the intervention, VLST is not common with BMS. PATIENTS AND METHODS: The pathogenesis of the VLST is poorly defined. Herein, we report two cases of VLST in which one a 62 year old male patient devoloped VLST of a BMS implanted in the right coronary artery (RCA) and presented inferior myocardial infarction and other a 48 year old male patient devoloped very late thrombosis of a BMS implanted in the RCA and presented inferior myocardial infarction, respectively. CONCLUSIONS: On the basis of these two cases and our review of the current literature we suggest that what can be done to prevent this rare but offending complication. Moreover, in the light of new imaging modalities such as optical coherence tomography (OCT), the pathophysiology of stent thrombosis will be clearly defined and preventive measures will be taken before occurs.