Publish in this journal
Journal Information
Vol. 71. Issue 12.
Pages 1069 (December 2018)
Image in cardiology
DOI: 10.1016/j.rec.2017.11.016
Full text access
Optical Coherence Tomography of Magnesium Bioresorbable Scaffold Restenosis
Tomografía de coherencia óptica en la reestenosis de armazón bioabsorbible de magnesio
Visits
...
Sergio García-Blas
Corresponding author
sergiogarciablas@gmail.com

Corresponding author:
, Gema Miñana, Juan Sanchis
Servicio de Cardiología, Hospital Clínico Universitario de Valencia, INCLIVA, CIBER Cardiovascular, Valencia, Spain
This item has received
...
Visits
(Daily data update)
Article information
Full Text
Download PDF
Statistics
Figures (1)
Additional material (1)
Full Text

A 58 year-old man was referred to cardiac catheterization for progressive effort angina 8 months after implantation of a magnesium bioresorbable scaffold in the mid left anterior descending coronary artery. In the current angiogram, severe focal restenosis was diagnosed (Figure A). Optical coherence tomography imaging showed strut remnants visualized as a “dissolved bright box” with partially visible bright spot and poorly defined contours (Figure B-G arrows) with complete endothelial coverage (Figure B-G, Video of the supplementary material). Focal restenosis consisted of moderate neointimal growth with a homogeneous pattern over an underexpanded scaffold (Figure C-F). Overlapped strut remnants surrounded by hypointense tissue (Figure D-F, asterisk) were evident. The patient was successfully treated by everolimus-eluting stent implantation.

Figure
(0.61MB).

Serial optical coherence tomography findings in the BISOLVE-II trial showed that struts are hardly discernible at 6 months’ follow-up. However, the present case still showed struts in the process of resorption all along the scaffold at 8 months. The restenosis mechanism was mainly underexpansion together with neointimal growth. Underexpansion may be explained by focal calcium (Figure D-F, 1 to 3 o’clock); unfortunately, no optical coherence tomography imaging was performed in the first procedure, but predilatation and postdilatation with noncompliant balloon (1:1 balloon:vessel) should have warranted an adequate expansion. Moreover, strut overlap at this area may reflect some degree of late scaffold disruption, which may contribute to restenosis; this is an occasional finding in polymeric bioresorbable scaffold restenosis. Finally, hypointense areas surrounding strut remnants have not been described after magnesium bioresorbable scaffold, but similar “low-signal” images have been observed in first-generation stents and may correlate with chronic inflammation.

FUNDING

CIBER CV 16/11/00420 FEDER.

Copyright © 2017. Sociedad Española de Cardiología
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.