Author + information
- Received August 31, 2016
- Revision received October 27, 2016
- Accepted November 3, 2016
- Published online December 28, 2016.
- S1936879816319847-5dbfa62caf605405b548142b6bbe6797Noriaki Moriyama, MD∗ (, )
- S1936879816319847-834e88e64ce3174677a02c78e8e5a95aKoki Shishido, MD,
- S1936879816319847-9d4c25d4316d043876eb69fc9340098aKazuki Tobita, MD,
- S1936879816319847-5ecc1b8a0e0c20547e16855900ff20d5Takuma Takada, MD,
- S1936879816319847-6a010362783f6923ae6ec0b3f11181c1Tomoki Ochiai, MD,
- S1936879816319847-4f3de18074304a6438d91a7e320670f7Saori Tsukuda, MD,
- S1936879816319847-599618bf99f31fdf22332bb7af0f2224Futoshi Yamanaka, MD,
- S1936879816319847-31ddfcdc9449f8f2f80374abe5c2e09dKazuya Sugitatsu, MD,
- S1936879816319847-35830357fe6ae42fbef7319734a913daShingo Mizuno, MD,
- S1936879816319847-6ac37740a93d2bff372a0bdb1d460103Yutaka Tanaka, MD, PhD,
- S1936879816319847-40afe5c25df20e924356a54dcb313d8eMasato Murakami, MD, PhD,
- S1936879816319847-79c2e98008ba524f7065ccca764a35b0Junya Matsumi, MD,
- S1936879816319847-fc3e885e16c4a01d853206302a2f80dbSaeko Takahashi, MD,
- S1936879816319847-3e3bb502e2914d0314e90edd24f0c4bfTakeshi Akasaka, MD, PhD and
- S1936879816319847-00d38c2fa5059395511b6425f700176dShigeru Saito, MD
- Department of Cardiology and Catheterization Laboratory, Shonan Kamakura General Hospital, Kamakura, Japan
- ↵∗Reprint requests and correspondence:
Dr. Noriaki Moriyama, Department of Cardiology and Catheterization Laboratory, Shonan Kamakura General Hospital, 1370-1 Okamoto, Kamakura, Kanagawa 247-8533, Japan.
A-74-year-old man included in the ABSORB EXTEND Clinical Investigation (NCT01023789) underwent percutaneous coronary intervention with an everolimus-eluting bioresorbable vascular scaffold (BVS) (Absorb BVS1.1, Abbot Vascular, Santa Clara, California) 3.0 × 18 mm in proximal right coronary artery for stable angina. After post-dilation at high pressure (20 atm) with 3.25 mm noncompliant balloon, an excellent angiographic result was obtained. Final optical coherence ;tomography (OCT) imaging revealed adequate apposition and symmetrical expansion (Figures 1A to 1C).
Serial OCT imaging follow-up at 1 and 5 years was performed. At 1 year, OCT detected neointimal coverage for the most part of strut with “black box” appearance. However, neointimal thickness at the distal portion of BVS was significantly thinner than other portions (Figures 1D to 1F and 1D' to 1F'). At 5 years after implantation, OCT confirmed nearly complete scaffold resorption in the proximal segments but “black box” objectives remained visible at the distal end of BVS (Figures 1G to 1I). It looked like the empty shell of a scaffold that was 140 to 150 μm thick. It was exactly equivalent to the thickness of Absorb BVS1.1 (Figures 2A and 2B). Additionally, a part of intima on “black box” was disconnected (Figure 2C).
In previous studies, mean intimal thickness was over than thickness of BVS at 6 months (1); furthermore, the struts were no longer discernable at 5 years by OCT (2,3). In contrast, “black box” structures, which had same configuration and thickness as the BVS, were confirmed in this case at 5 years. It has been speculated that abnormal strut resorption process might be participated. OCT finding at 1 year showed unusual insufficient intimal growth only at the distal end of scaffold. Delayed BVS endothelialization might be one of the factors for abnormal resorption process. Here, we show the first case of incomplete absorption for BVS at 5 years. This finding should be investigated to figure out resorption process of BVS in greater detail.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 31, 2016.
- Revision received October 27, 2016.
- Accepted November 3, 2016.
- American College of Cardiology Foundation
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