{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:49:51Z","timestamp":1753876191701,"version":"3.41.2"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,11,30]],"date-time":"2021-11-30T00:00:00Z","timestamp":1638230400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Very-very late stent thrombosis (VVLST) occurring more than 5 years after implantation of drug-eluting stent (DES) is extremely rare, being restricted to few case reports. Mainly described with first-generation stents, this life-threatening complication has not been described with later-generation stents. We describe the first case of VVLST occurring 3309 days (&amp;gt;9 years) after implantation of second-generation DES.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>A 62-year-old man presented with the acute coronary syndrome. He has a history of percutaneous coronary intervention (PCI) to the right coronary artery using the three second-generation DES more than 9 years ago. Coronary angiogram revealed in-stent restenosis (ISR) with doubtful angiographic thrombus. Optical coherence tomography (OCT) confirmed the diagnosis of stent thrombosis (STh) localized to the stent overlap zone with underlying ISR. Patient underwent OCT-guided PCI with DES implantation and was discharged on dual antiplatelet therapy including ticagrelor. He is doing well on follow-up at 6 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>Stent thrombosis can occur in second-generation stents nearly a decade after implant. Stent overlap segment is more prone to neo-atheroma formation and vulnerable plaque leading to STh. In addition to confirming the diagnosis, OCT provides exciting insights into the underlying mechanism. This has implications for long-term antiplatelet therapy in patients implanted with multiple stents.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab490","type":"journal-article","created":{"date-parts":[[2021,12,1]],"date-time":"2021-12-01T14:46:34Z","timestamp":1638369994000},"source":"Crossref","is-referenced-by-count":0,"title":["Optical coherence tomographic insights of very late stent thrombosis of a second-generation drug-eluting stent: a case report"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8151-6452","authenticated-orcid":false,"given":"Parminder Singh","family":"Otaal","sequence":"first","affiliation":[{"name":"Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Room No 3007, Sector-12, Chandigarh 160012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1625-7436","authenticated-orcid":false,"given":"Atit A","family":"Gawalkar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Room No 3007, Sector-12, Chandigarh 160012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-088X","authenticated-orcid":false,"given":"Ajay","family":"Shunmugarajan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education and Research, Room No 3007, Sector-12, Chandigarh 160012, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2021,11,30]]},"reference":[{"key":"2021121412310913600_ytab490-B1","first-page":"221","article-title":"Early stent thrombosis. 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