Successful treatment of perioperative very late stent thrombosis with thromboaspiration device.

I read with interest the article by S Sikdar et al on “Perioperative Very Late Stent Thrombosis treated with Thrombosuction” . The authors highlighted a very pertinent issue regarding the perioperative management conundrum of antiplatelet therapy in the setting of prior coronary stent implantation. Cypher ® (Cordis, Johnson & Johnson, Bridgewater, NJ) is a sirolimus drug eluting stent. As pointed out by the authors, the 2007 Focus Update of American College of Cardiology (ACC)/American Heart Association (AHA) /Society for Cardiovascular Angiography and Interventions (SCAI) recommended at least 3 months of clopidogrel treatment in combination with long term aspirin after sirolimus drug eluting stent (DES) implantation. However, the extended duration of 5 years dual antiplatelet therapy(DAT) has not been well established. We do not know the reason for the patient’s 5 year extended DAT.