Progressive growth of coronary aneurysms after bioresorbable vascular scaffold implantation: Successful treatment with OCT‐guided exclusion using covered stents

Abstract

The development and progressive enlargement over time of multiple saccular coronary artery aneurysms (CAA) after implantation of everolimus‐eluting stent and bioresorbable vascular scaffolds (BVS) have been reported. CAA was successfully excluded by two overlapped covered stents expanded inside a long metallic drug‐eluting stent to avoid dislodgment at the overlap point. Optical coherence tomography (OCT) was repeatedly performed to monitor CAA expansion and to guide treatment through precise measurement of aneurysm length and vessel size at the landing zone. At 10‐month follow‐up, coronary computed tomography angiography showed persistent CAA exclusion. To the best of our knowledge, this is the first report of this technique to exclude a long CCA segment.

Late acquired coronary aneurysm and restenosis after bioresorbable vascular scaffold implantation: a case report

“…A conservative approach has been generally chosen by prescribing DAPT to prevent aneurysm thrombosis, 3 , 10 whereas covered stents have been used to exclude the aneurysm whenever progressive growth over time is observed. 11 The use of oral anticoagulants (for instance a vascular dose of rivaroxaban, 2.5 mg twice daily) in addition to aspirin may be also considered for long-term thrombosis prevention in cases managed conservatively, especially whenever with polyvascular atherosclerotic disease is present.…”