Recurrent episode of very late stent thrombosis in a patient who underwent percutaneous coronary intervention with sirolimus-eluting stent: Same or different mechanism?

We describe a case of a young patient with a recurrent episode of very late stent thrombosis (VLST) in whom the sirolimus-eluting stent was implanted on the culprit lesion in the left anterior descending artery. The present case showed when the etiology of VLST was not clear or in doubt of stent fracture, vigorous investigation for other causes using high resolution technology such as intravascular ultrasound or computed tomography angiography might be helpful for prevention of catastrophic events such as VLST.