Abstract
A 72-year-old male who had performed 13 months earlier a percutaneous coronary intervention (PCI) for unstable angina with 3 overlapping bioresorbable vascular scaffolds (BVSs) (Abbott Vascular, Santa Clara, California) in a long lesion of the left anterior descending (LAD), presented with new onset effort angina. Coronary angiography revealed significant focal in-scaffold restenosis of the distal LAD (Fig. 1, black arrow). Optical coherence tomography (OCT) imaging (Fig. 2) showed good expansion of the scaffolds with minimum neointima coverage (A, D), except for a focal under-expansion with severe prominent neointimal hyperplasia located in the body of the distal scaffold (B, C). Minimum lumen area (MLA) was 0.9 mm2. At the site of MLA there was evidence of structural discontinuity (white arrow), and of thin black holes likely due to neovascularization of the neointima (*). After pre-dilation with a 2.5–15-mm non-compliant balloon, a 2.75–16 mm DES was successfully implanted. Fig. 2Optical coherence tomography imaging of distal LAD. At the restenosis site there was evidence of structural discontinuity (white arrow), and neovascularization of the neointima (*). View Large Image Figure Viewer Download Hi-res image
Published Version
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