title: Intraluminal bioresorbable vascular scaffold dismantling with aneurysm formation leading to very late thrombosis.
abstract: Coronary artery aneurysm formation has been described in patients after the placement of first-generation drug-eluting stents (DES), but is less common with newer generation metallic stents. In contrast, coronary artery aneurysm formation may be more common with the use of bioresorbable vascular scaffolds (BVS) due to the frequent formation of evaginations in the arterial wall seen with BVS. In this article, we describe a unique case of BVS dismantling and thrombus formation leading to an acute coronary syndrome thirty-two months after initial BVS placement. We also discuss existing literature and the pathophysiology of BVS degradation, in addition to the utility of optical coherence tomography in the identification of associated conditions, such as strut fracture, intraluminal scaffold dismantling (ILSD), under-expansion, and/or malapposition. © 2017 Wiley Periodicals, Inc.
authors.affiliation: Columbia University Medical Center and New York Presbyterian Hospital, New York, New York.
authors.forename: Amisha
authors.initials: A
authors.lastname: Patel
authors.affiliation: Columbia University Medical Center and New York Presbyterian Hospital, New York, New York.|Cardiovascular Research Foundation, New York, New York.
authors.forename: Tamim
authors.initials: T
authors.lastname: Nazif
authors.affiliation: Columbia University Medical Center and New York Presbyterian Hospital, New York, New York.|Cardiovascular Research Foundation, New York, New York.
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.affiliation: Columbia University Medical Center and New York Presbyterian Hospital, New York, New York.|Cardiovascular Research Foundation, New York, New York.
authors.forename: Ziad A
authors.initials: ZA
authors.lastname: Ali
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects*; D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D003323:Coronary Aneurysm / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000601:surgery*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D006083:Graft Occlusion, Vascular / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D000072658:Non-ST Elevated Myocardial Infarction / Q000175:diagnosis / Q000601:surgery*; D011474:Prosthesis Design; D017131:Thrombectomy / Q000379:methods; D054457:Tissue Scaffolds / Q000009:adverse effects*; D041623:Tomography, Optical Coherence
keywords: acute coronary syndromes; bioresorbable vascular scaffold; optical coherence tomography