title: Lessons Learned Regarding Handling and Deployment of the Absorb Bioresorbable Vascular Scaffold in Infrapopliteal Arteries.
abstract: To describe relevant technical details with which to facilitate safe and effective use of the Absorb coronary bioresorbable vascular scaffold (BVS) in lower extremity arteries.
  
  
  
  The Absorb BVS is a balloon-expandable, poly-l-lactide structure covered in a poly-d,l-lactide bioresorbable polymer that contains the antiproliferative drug everolimus. As a polymeric structure, it has a number of unique physical, handling, and imaging properties that may differ from metallic stents and pose a challenge to the interventionist. Attention must be paid to lesion selection, preparation, scaffold sizing, deployment, and postdilation to achieve optimal outcomes. A detailed description of these issues and deployment techniques is offered based on experience using this BVS in below-the-knee arteries.
  
  
  
  The Absorb BVS may have application in the infrapopliteal circulation; however, its unique properties warrant careful consideration before use in the lower limb.
authors.affiliation: 1 Department of Surgery, Prince of Wales Hospital, Sydney, Australia.|2 Faculty of Medicine, University of New South Wales, Sydney, Australia.|3 The Vascular Institute, Prince of Wales, Sydney, Australia.
authors.forename: Ramon L
authors.initials: RL
authors.lastname: Varcoe
authors.affiliation: 1 Department of Surgery, Prince of Wales Hospital, Sydney, Australia.|2 Faculty of Medicine, University of New South Wales, Sydney, Australia.|3 The Vascular Institute, Prince of Wales, Sydney, Australia.
authors.forename: Shannon D
authors.initials: SD
authors.lastname: Thomas
authors.affiliation: 4 Abbott Vascular, Santa Clara, CA, USA.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Rapoza
authors.affiliation: 5 Vascular Service, Department of Surgery, Changi General Hospital, Singapore.
authors.forename: Steven
authors.initials: S
authors.lastname: Kum
mesh_terms: D020341:Absorbable Implants; D000792:Angiography; D000800:Angioplasty, Balloon / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage; D020099:Coated Materials, Biocompatible; D000068338:Everolimus / Q000008:administration & dosage; D006801:Humans; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011091:Polyesters / Q000737:chemistry; D011150:Popliteal Artery / Q000000981:diagnostic imaging / Q000503:physiopathology; D011474:Prosthesis Design; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D011091:Polyesters; C033616:poly(lactide); D000068338:Everolimus
keywords: absorbable implant; angioplasty; below the knee; bioresorbable vascular scaffold; infrapopliteal arteries; ischemia; lower extremity; occlusion; peripheral artery disease; polymers; stenosis; stent