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Absorb user forum bvs in bifurcation dr vsp

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vishwanath69

A 55-year-old male with diabetes and previous coronary artery disease underwent coronary angiography (CAG) which showed 50% lesion in the left anterior descending artery and a tight stenosis with calcium in the D1 branch. Percutaneous coronary intervention (PCI) was performed on the D1 branch with balloon angioplasty followed by deployment of an Absorb bioresorbable vascular scaffold (BVS). Optical coherence tomography (OCT) showed under expansion of the distal part of the scaffold. High pressure balloon dilatation was then performed to achieve complete apposition, which OCT confirmed along with decreased subintimal staining. The message conveyed is that BVS require proper preparation for calcific lesions, high pressure ballooning

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Clinical History: 55 Yrs Male. DM Previous CAG 2009, Class II Angina TMT Positive for inducible ischaemia Normal LV Function by 2D Echo
CAG CAG at Right Radial Approach LAD after D1 50% lesion, Proximal Calcium. D1 - Medina : 0,0,1 , Tight Stenoses with Calcium.
Strategy: Deploy Absorb - BVS after POBA to D1
PCI Hardware: Rt Radial approach -6F Teurmo sheath, Guiding: EBU 3.5-6F, Guide wire: -BMW to D1. QCA: D1 80% stenosis, Diameter: 2.5mm, length: 15mm.
PCI POBA done with 2.5x10 NC at 10 atm Sub-intimal staining at the lesion and branch site
PCI BVS Absorb 2.5 x 18mm.
Scaffold deployed Absorb BVS deployed at nominal press. of 7 atm 30sec with incremental pressure of 2 atm at 5 sec interval.
PCI OCT checked calcium with fibro- OCT did show under expansion at distal fatty plaque is present at the site of part of lesion and sub intimal collection lesion and distal .
PCI High Pressure dilatation with 2.5x10 and 2.75x15 NC Balloons at 12 atm done for complete apposition of Scaffold.
PCI OCT showed better apposition and sub intimal staining decreasing. Side branch well protected.
PCI LAO Cranial View provided a better impression of stent apposition,
Message BVS Absorb needs proper bed preparation with NC Balloon for calcific lesions. High Pressure Dilatation with sub Intimal Collection can lead to vessel damage and perforation. OCT guidance is obligatory for Absorb BVS.
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Absorb user forum bvs in bifurcation dr vsp

  • 1. Clinical History: 55 Yrs Male. DM Previous CAG 2009, Class II Angina TMT Positive for inducible ischaemia Normal LV Function by 2D Echo
  • 2. CAG CAG at Right Radial Approach LAD after D1 50% lesion, Proximal Calcium. D1 - Medina : 0,0,1 , Tight Stenoses with Calcium.
  • 3. Strategy: Deploy Absorb - BVS after POBA to D1
  • 4. PCI Hardware: Rt Radial approach -6F Teurmo sheath, Guiding: EBU 3.5-6F, Guide wire: -BMW to D1. QCA: D1 80% stenosis, Diameter: 2.5mm, length: 15mm.
  • 5. PCI POBA done with 2.5x10 NC at 10 atm Sub-intimal staining at the lesion and branch site
  • 7. Scaffold deployed Absorb BVS deployed at nominal press. of 7 atm 30sec with incremental pressure of 2 atm at 5 sec interval.
  • 8. PCI OCT checked calcium with fibro- OCT did show under expansion at distal fatty plaque is present at the site of part of lesion and sub intimal collection lesion and distal .
  • 9. PCI High Pressure dilatation with 2.5x10 and 2.75x15 NC Balloons at 12 atm done for complete apposition of Scaffold.
  • 10. PCI OCT showed better apposition and sub intimal staining decreasing. Side branch well protected.
  • 11. PCI LAO Cranial View provided a better impression of stent apposition,
  • 12. Message BVS Absorb needs proper bed preparation with NC Balloon for calcific lesions. High Pressure Dilatation with sub Intimal Collection can lead to vessel damage and perforation. OCT guidance is obligatory for Absorb BVS.