Treatment of in-stent restenosis with bioresorbable vascular scaffolds: optical coherence tomography insights

Can J Cardiol. 2015 Mar;31(3):255-9. doi: 10.1016/j.cjca.2014.11.017. Epub 2014 Nov 22.

Abstract

The role of the bioresorbable vascular scaffold (BVS) in patients with in-stent restenosis (ISR) remains unsettled. We present optical coherence tomography (OCT) findings in a series of 15 consecutive patients undergoing treatment of ISR with a BVS under systematic OCT guidance. OCT disclosed severe ISR in all patients (minimal lumen area [MLA], 1.3 ± 0.6 mm(2); stent obstruction 80% ± 10%). After the procedure, OCT MLA was 6.4 ± 2 mm(2) with a final BVS expansion of 79% ± 19%. "Angiographically silent" edge dissections (n = 6), intradevice dissections (n = 3), tissue prolapse (n = 3), and malapposition (n = 3) were also readily visualized. These findings underscore the diagnostic value of OCT in patients undergoing BVS implantation for ISR.

MeSH terms

  • Absorbable Implants*
  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary* / methods
  • Coronary Restenosis / diagnosis*
  • Coronary Restenosis / therapy*
  • Drug-Eluting Stents / adverse effects*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prospective Studies
  • Prosthesis Design
  • Prosthesis Failure
  • Risk Factors
  • Sensitivity and Specificity
  • Tissue Scaffolds*
  • Tomography, Optical Coherence* / methods
  • Treatment Outcome