Early disarticulation of a bioresorbable vascular scaffold: an underreported consequence of repeat imaging

Excerpt

A 54 year-old male presented with a non ST-elevation myocardial infarction. Coronary angiography revealed significant stenoses in the proximal left anterior descending (LAD) and circumflex arteries. The LAD lesion had only mild calcification and was not tortuous. It was 1:1 (balloon:vessel) pre-dilated and a 3.5 × 18 mm absorb bioresorbable vascular scaffold (BVS, Abbott Vascular, USA) was deployed at 14 atmospheres and optimized with a 4.0 × 12 mm non-compliant balloon to 10 atmospheres. Post-deployment optical coherence tomography (OCT, Dragonfly C7XR, St. Jude Medical, USA) showed a well-expanded and apposed scaffold with no evidence of scaffold strut fracture (Fig. 1a and Supplementary Video). The patient was discharged with the intention of staged PCI to the circumflex. Following successful FFR-guided PCI to the circumflex 58 days later, OCT reimaging of the LAD demonstrated disarticulation of a distal portion of the BVS (Fig. 1b and Supplementary Video). The distal portion of the BVS was 4.1 mm distal to the main body of the scaffold.

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