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A Case of Subacute Bioresorbable Vascular Scaffold Thrombosis, What was Wrong?

Unusual clinical course, Unusual or unexpected effect of treatment, Diagnostic / therapeutic accidents, Educational Purpose (only if useful for a systematic review or synthesis)

Seraj A. Abualnaja, Hanan M. Alrammah, Bayan A. Alsaif, Malak O. Almulla, Bayan A. Alzahrani

(Department of Internal Medicine, Imam Abdulrahman bin Faisal University, Dhahran, Saudi Arabia)

Am J Case Rep 2017; 18:1343-1346

DOI: 10.12659/AJCR.906476

Published: 2017-12-16


BACKGROUND: The introduction of bioresorbable vascular scaffolds (BVS) into the field of percutaneous coronary intervention (PCI) was thought to be a promising step in solving the issues raised with the use of early bare metal stents (BMS) and drug eluting stents (DES); however, studies have raised concerns regarding thrombosis risk associated with the use of these stents.
CASE REPORT: A 42-year-old male presented with acute coronary syndrome (ACS), on diagnostic coronary angiography he had 75% and 70% stenosis in mid and distal left anterior descending artery (LAD) respectively, PCI with BVS implantation was done. A week later, he came with non-ST segment elevation myocardial infarction due to an in-stent thrombosis. Procedures to open the LAD were done with multiple balloon angioplasties and aspiration thrombectomy, following aggressive dilatation there was a class-III perforation which was sealed by covered stent. A second look angiography was done which showed patent LAD and well expanded stents. 
CONCLUSIONS: Since several factors play a role in decision-making regarding the selection of patient in whom BVS usage can be beneficial, larger studies are needed. Moreover, the safety profile of BVS should be investigated thoroughly. 

Keywords: Angioplasty, Coronary Thrombosis, percutaneous coronary intervention



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