10-Year optical coherence tomography follow-up of ‘full-plastic jacket’ with bioresorbable vascular scaffolds

In 2013, a 54-year-old diabetic male underwent multivessel percutaneous coronary intervention with implantation of multiple everolimus-eluting bioresorbable scaffolds (BRS, Absorb, Abbott Vascular) under optical coherence tomography (OCT) guidance. A total BRS length of 196 mm was implanted in the mid and distal portion of the left anterior descending artery (LAD), in the right coronary artery, and in the obtuse marginal branch (Panel A, dashed yellow lines). The proximal LAD and left circumflex stenosis were treated with drug-eluting stents (Panel A, dashed white lines). Coronary angiography and OCT follow-up at 2 years showed good angiographic result and partial dismantling of the scaffold struts.1 At 5 years, complete scaffold resorption and onset of coronary ectasia with evidence of positive vessel remodelling, particularly in the mid and distal LAD segments, were documented at OCT (Panel B). Ten-year angiographic follow-up did not show any progression of atherosclerotic disease nor of coronary ectasia, without significant variation of vessel lumen area at OCT. This case represents the first 10-year OCT follow-up of a multivessel ‘full-plastic jacket’ BRS percutaneous revascularization. It could be speculated that the onset of coronary ectasia in predisposed subjects might be linked to the everolimus’ anti-proliferative effect and/or to the poly-l-lactic acid itself, and thus the observed positive remodelling process ceases after the BRS scaffold disappears. Supplementary data are not available at European Heart Journal online. All authors declare no disclosure of interest for this contribution. No data were generated or analysed for this manuscript. Full OCT and angiographic images are available upon reasonable request.