Disappearing stent but persisting problems? Optical coherence tomography assessment of intra-scaffold restenosis
A 72-year-old male who had performed 13 months earlier a percutaneous coronary intervention (PCI) for unstable angina with 3 overlapping bioresorbable vascular scaffolds (BVSs) (Abbott Vascular, Santa Clara, California) in a long lesion of the left anterior descending (LAD), presented with new onset effort angina. Coronary angiography revealed significant focal in-scaffold restenosis of the distal LAD (Fig. 1, black arrow). Optical coherence tomography (OCT) imaging (Fig. 2) showed good expansion of the scaffolds with minimum neointima coverage (A, D), except for a focal under-expansion with severe prominent neointimal hyperplasia located in the body of the distal scaffold (B, C).