Di Serafino L, Cirillo P, Niglio T, Borgia F, Trimarco B, Esposito G, Stabile E. Very late bioresorbable scaffold thrombosis and reoccurrence of dissection two years later chronic total occlusion recanalization of the left anterior descending artery. World J Cardiol 2017; 9(8): 710-714 [PMID: 28932360 DOI: 10.4330/wjc.v9.i8.710]
Corresponding Author of This Article
Plinio Cirillo, MD, PhD, Associate Professor of Cardiology, Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples “Federico II”, via Sergio Pansini, 5, 80131 Naples, Italy. pcirillo@unina.it
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Aug 26, 2017; 9(8): 710-714 Published online Aug 26, 2017. doi: 10.4330/wjc.v9.i8.710
Very late bioresorbable scaffold thrombosis and reoccurrence of dissection two years later chronic total occlusion recanalization of the left anterior descending artery
Luigi Di Serafino, Plinio Cirillo, Tullio Niglio, Francesco Borgia, Bruno Trimarco, Giovanni Esposito, Eugenio Stabile
Luigi Di Serafino, Plinio Cirillo, Tullio Niglio, Francesco Borgia, Bruno Trimarco, Giovanni Esposito, Eugenio Stabile, Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples “Federico II”, 80131 Naples, Italy
Author contributions: All authors have participated in the work, have reviewed and agree with the content of the article; in particular, Di Serafino L and Cirillo P performed the last interventional procedure; Di Serafino L, Cirillo P and Stabile E wrote the manuscript; Niglio T and Borgia F collected the data; Di Serafino L, Cirillo P, Esposito G and Stabile E drafted the manuscript; all authors critically revised the manuscript and gave final approval.
Institutional review board statement: This case report conforms to the ethical standards of our institution.
Informed consent statement: The patient involved in this study gave his verbal informed consent authorizing use of his protected health information.
Conflict-of-interest statement: All the authors have no conflicts of interests to declare.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Plinio Cirillo, MD, PhD, Associate Professor of Cardiology, Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples “Federico II”, via Sergio Pansini, 5, 80131 Naples, Italy. pcirillo@unina.it
Telephone: +39-81-7462235 Fax: +39-81-7462235
Received: January 26, 2017 Peer-review started: February 7, 2017 First decision: May 11, 2017 Revised: May 22, 2017 Accepted: June 19, 2017 Article in press: July 17, 2017 Published online: August 26, 2017 Processing time: 209 Days and 6.9 Hours
Abstract
We describe the case of a patient presenting with ST-segment elevation myocardial infarction due to very late scaffold thrombosis. The patient was already admitted for an elective percutaneous recanalization of a chronically occluded left anterior descending artery (LAD). The procedure was performed according the sub-intimal tracking and re-entry (STAR) technique with 4 bioresorbable vascular scaffolds implantation. However, even though the coronary flow was preserved at the end of the procedure, the dissected segment was only partially sealed at the distal segment of the LAD. After 18 mo of regular assumption, dual antiplatelet therapy was discontinued for 10 mo before his presentation at the emergency room. This is the first reported case of a very late scaffold thrombosis after coronary chronic total occlusion (CTO) recanalization performed according to the STAR technique. This case raises concerns about the risk of very late scaffold thrombosis after complex CTO revascularization.
Core tip: We describe a case of a 53-year-old male patient who was admitted with anterior ST-elevation myocardial infarction 28 mo after elective percutaneous revascularization of a chronically occluded left anterior descending (LAD) threated with 4 bioresorbable vascular scaffolds (BVS) in order to seal a long flow limiting dissection after sub-intimal tracking and re-entry technique. Coronary angiography showed a large thrombus at the proximal segment of the proximal BVS and a long dissection was evident from mid to distal LAD. In this case, the progressive reduction of both scaffolds radial strength and structure dismantling might have been responsible for both intraluminal thrombosis and reoccurrence of vessel dissection.
