Brief Rapid Report Treatment of In-Stent Restenosis With Bioresorbable Vascular Scaffolds: Optical Coherence Tomography Insights

The role of the bioresorbable vascular scaffold (BVS) in patients with instent restenosis (ISR) remains unsettled. We present optical coherence tomography (OCT) findings in a series of 15 consecutive patients undergoing treatment of ISR with a BVS under systematic OCT guidance. OCT disclosed severe ISR in all patients (minimal lumen area [MLA], 1.3 � 0.6 mm 2 ; stent obstruction 80% � 10%). After the procedure, OCT MLA was 6.4 � 2m m 2 with a final BVS expansion of 79% � 19%. “Angiographically silent” edge dissections (n ¼ 6), intradevice dissections (n ¼ 3), tissue prolapse (n ¼ 3), and malapposition (n ¼ 3) were also readily visualized. These findings underscore the diagnostic value of OCT in patients undergoing BVS implantation for ISR.