1. Treatment of Coronary In-Stent Restenosis With Bioabsorbable Vascular Scaffolds

    Treatment of Coronary In-Stent Restenosis With Bioabsorbable Vascular Scaffolds

    A 77-year-old woman was admitted for angina 13 years after receiving a bare-metal stent in the left anterior descending coronary artery. Angiography showed in-stent restenosis (ISR). Optical coherence tomography (OCT) revealed a well-expanded stent with focal ISR ( arrow in longitudinal display, A ) and heterogeneous tissue, including lipid pools (+) and and calcified segments (#) , suggesting neoatherosclerosis (B to D) (wire-artifact [*] ). Most underlying struts were not visible. A bioabsorbable vascular scaffold (BVS) was deployed and subsequently post-dilated at high pressures to remove a residual waist. Final OCT revealed a minimal lumen area of 8 mm 2 . The classic “ black box ” BVS appearance (without ...

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