Challenges in the Long-Term Management of Stent-Related Complications: A Case of Recurrent Stent Thrombosis and Restenosis.

Coronary stenting has substantially enhanced revascularization outcomes; however, in-stent restenosis (ISR) and stent thrombosis (ST) remain significant complications associated with increased morbidity and mortality. We present the case of a 63-year-old male with a history of ischemic heart disease who underwent percutaneous coronary intervention (PCI) for proximal left anterior descending (LAD) and right coronary artery (RCA) stenoses. Over a five-and-a-half-year follow-up period, he experienced two distinct episodes of ST, one occurring early and the other classified as very late, as well as a single occurrence of ISR, each requiring targeted interventional management. This case highlights the complex interplay of mechanisms underlying recurrent stent failure, emphasizing the need for personalized management and ongoing refinement of stent technologies and adjunctive therapies to improve long-term clinical outcomes.