Warning: Speed bump on the DES road

We have been posting much about the goodness of DES (drug-eluting stents) with some even heralding this as a revolutionary treatment in PCI (percutanous coronaary intervention). Well, on 7th May 2006, I received a very unpleasant phone call that one of my patient who had three cyphers stents (sirolimus eluting stents) implanted in 2004, had a stress ECG done in late 2005, which was normal, who was last reviewed by me two months ago, and was well, suddenly collapsed and died on Sunday. Was rushed to another medical center and pronounced dead on arrival. Of course there were many possibilities as to the cause of death. One of this is late stent thrombosis in my sirolimus eluting stents, occuring 2 years after successful stent implantation. This may be an illustration of this, late stent thrombosis problem. And this problem could be due to accidental discontinuation of plavix. This patient had his plavix stopped about 1 year after the stents were implanted.

A sober warning for all of us who think that the drug eluting stents were so good. That is true, but there are problems, like this case of sudden cardiac death from possible late stent thrombosis.