Stent thrombosis after complex multivessel stenting in an elderly patient.

We report a challenging case in terms of procedural difficulty as well as long-term patency. Multivessel stenting procedures for long subtotal occlusions in the right coronary artery (RCA) and left anterior descending coronary artery (LAD) were successfully performed in an 84-year-old female who had complications of severe left ventricular dysfunction and a recent history of gastric ulcer bleeding. Two bare-metal stents were successfully deployed in the mid and distal RCA. A drug-eluting stent could only be deployed in the proximal RCA. Two drug-eluting stents were deployed in the proximal LAD and LMT. Late stent thrombosis in the proximal RCA occurred about 3 months later. We speculated that a lack of aspirin and bare metal stent restenosis were the reasons for the late stent thrombosis. This case was very challenging in terms of balancing the risk of ischemia and bleeding after coronary stent deployment.