Very late bioresorbable scaffold thrombosis and reoccurrence of dissection two years later chronic total occlusion recanalization of the left anterior descending artery

Figure 1 Baseline chronic total occlusion-percutaneous revascularization of the left anterior descending. A and B: Mid-LAD occlusion with omolateral reperfusion of the distal segment; C: Dissected segment after CTO recanalization and balloon dilation (white arrows); D: Final result after four BVS implantation and (2) contrast staining at the distal LAD suggesting the presence of subintimal hematoma with the occlusion of the distal apical branch (1). BVS: Bioresorbable vascular scaffolds; LAD: Left anterior descending; CTO: Chronic total occlusion.

Figure 2 Coronary angiography of the left anterior descending at 28 mo after chronic total occlusion recanalization. A and B: Large in-scaffold thrombus at the proximal edge of the previously implanted BVS (C, D, white boxes), at the mid LAD (*); E and F: Dissected segment (white arrows) from the mid-LAD up to the distal segment, with a resulting image of a “dual lumen” LAD. LAD: Left anterior descending; BVS: Bioresorbable vascular scaffolds.

Figure 3 Percutaneous revascularization of the left anterior descending. A and B: After coronary wire crossing, thrombus aspiration was successfully performed (*) and a drug eluting stent was finally implanted with good final result (C).