Shoichi Kuramitsu, Hiroaki Matsuda, et al
The sirolimus-eluting stent (SES) was the most widely used firstgeneration drug-eluting stent (DES) and dramatically reduced the rate of in-stent restenosis and subsequent target lesion revascularisation (TLR) compared with bare metal stents (BMS)1. Pivotal randomised clinical trials have demonstrated that the efficacy of SES was sustained without any significant increase of stent thrombosis (ST) up to four to five years after implantation2,3. However, in real-world clinical practice, late adverse events such as very late ST (VLST) and late TLR beyond one year have emerged as unsolved issues after SES implantation4-8.