‘Full-plastic jacket’ with bioresorbable vascular scaffolds: 5-year optical coherence tomography follow-up

Extract

A 54-year-old male patient with type 2 diabetes mellitus and dyslipidaemia was referred to our catheterization laboratory for unstable angina. Coronary angiography revealed severe diffuse and distal three-vessel coronary artery disease. The patient refused bypass surgery and was therefore scheduled for multivessel percutaneous coronary intervention. Following the PSP (pre-dilatation, vessel sizing, post-dilatation) strategy, three 3.0 × 28 mm everolimus-eluting bioresorbable scaffolds (BRS, Absorb, Abbott Vascular, USA) were implanted in the left anterior descending (LAD) artery, three 3.0 × 28 mm BRS in the right coronary artery (RCA) and one single 2.5 × 28 mm BRS was deployed in the obtuse marginal branch (Panel A, dashed yellow lines). Proximal LAD and left circumflex were treated with 2nd generation drug-eluting stents (Panel A, dashed white lines). Coronary angiography and optical coherence tomography (OCT—Panel B) after 2 years showed no scaffold restenosis and partial struts dismantling. At 5-year follow-up, coronary angiography demonstrated good angiographic result, with the presence of mild coronary ectasia. OCT evaluation showed complete resorption of the scaffolds, associated with positive vessel remodelling, as shown by the increase of lumen area (in the selected LAD section from 4.45 mm² at baseline to 4.85 mm² at 5-year follow-up; in the selected RCA section from 6.14 mm² at baseline to 6.34 mm² at 5-year follow-up).