Author + information
- Antonios Karanasos, MD,
- Hector M. Garcia-Garcia, MD, PhD,
- Robert-Jan van Geuns, MD, PhD and
- Evelyn Regar, MD, PhD∗ ()
- ↵∗Reprint requests and correspondence:
Dr. Evelyn Regar, Department of Cardiology, Thoraxcenter, Room Ba585, Erasmus Medical Center, Molewaterplein 40, 3015 RD, Rotterdam, the Netherlands.
A 55-year-old man included in the ABSORB B trial (NCT00856856) underwent implantation of an everolimus-eluting bioresorbable vascular scaffold (BVS) (ABSORB BVS 1.1, Abbott Vascular, Santa Clara, California) in the mid–left anterior descending artery for stable angina. Optical coherence tomography (OCT) post-implantation disclosed severe malapposition near 2 septal branches: at the distal scaffold segment (Figure 1B) and at the proximal scaffold edge, including malapposition of the platinum scaffold marker (Figure 1C).
Serial OCT imaging at follow-up demonstrated gradual resolution of the malapposition due to tissue growth by 6 months (Figure 1C′) and 2 years (Figure 1B′′), with complete strut resorption by 5 years (Figures 1A′′′ to 1C′′′) and complete integration of the platinum marker in the vessel wall (Figure 1C′′′). Side-branch related nonapposed struts over the distal scaffold segment were gradually covered by tissue and completely resorbed, resulting in a tissue bridge overlying the side branch, confirmed by 3-dimensional rendering and analysis of a plane perpendicular to the side-branch centerline (QAngioOCT 1.0, Medis specials bv, Leiden, the Netherlands) (Figures 1D, E, Online Video 1) (1), with a pattern resembling the T-type jailing pattern described for BVS struts overhanging side branches (2).
It has been speculated that malapposed platinum markers could be a source of concern after strut resorption, with the potential for embolization. In our case, we witnessed the complete integration of the marker in the vessel wall despite baseline malapposition and tissue bridge formation over side branches at the long-term follow-up of BVS 1.1, the latter of which is in line with previous observations in BVS 1.0 (3).
The authors thank Dr. Shengxian Tu for providing the QAngioOCT software used for the 3-dimensional rendering.
For a supplemental video and its legend, please see the online version of this article.
Dr. Karanasos has received research support from St. Jude Medical. Dr. van Geuns has received research support from Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- 2015 American College of Cardiology Foundation
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