CTO 5 Years After Bioresorbable Vascular Scaffold Implantation: A Serial Optical Coherence Tomography Assessment

J INVASIVE CARDIOL 2020;32(5):E141.

Key words: cardiac imaging, optical coherence tomography

A 66-year-old man presented with ST-segment myocardial infarction. He underwent successful Absorb 1.0 bioresorbable vascular scaffold (Abbott Vascular) implantation. A prespecified 12-month and 24-month coronary angiography and optical coherence tomography showed preserved vessel patency with signs of peristrut low-intensity areas within the neointima and features of atherosclerosis progression at the distal edge of the scaffold (Figure 1). A prespecified angiography at 60 months revealed a total occlusion at the distal part of the scaffold. Within the proximal edge, optical coherence tomography showed a complete absorption of stent struts with a decreased mean scaffold area and diameter (Figure 1). First-generation bioresorbable vascular scaffolds failed to demonstrate benefit over the current best-in-class second-generation drug-eluting stents over long-term follow-up, yet the mechanisms underlying very late scaffold failure still are not sufficiently understood. Peristrut low-intensity areas within the neointima may herald abnormal healing, with late neointimal hyperplasia leading to total vessel occlusion.

From the 1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr. Tomaniak reports grant support as the Laureatte of the ESC Research and Training Program (ESC 2018 Grant). The remaining authors report no conflicts of interest regarding the content herein.

The authors report that patient consent was provided for publication of the images used herein.

Manuscript accepted November 12, 2019.

Address for correspondence: Mariusz Tomaniak, MD, PhD, 1st Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267, Warsaw, Poland. Email: mariusz.tomaniak@interia.pl