Bioresorbable vascular scaffold implantation for recurrent in-stent restenosis: an option in case of multiple failures?

An 80-year-old male underwent coronary angiography for unstable angina. He had a history of multiple PCI in the LCx towards OM1 due to recurrent in-stent restenosis (ISR) (bare metal stent-ISR treated with drug-eluting stent [DES]; DES-ISR treated with cutting and non-compliant [NC] balloons; new DES-ISR treated with drug-eluting balloon). The angiography showed a recalcitrant multifocal ISR on OM1 (Figure 1A, Figure 1B). Although off-label, we treated the ISR with two (3.5×18 mm and 3.5×28 mm) bioresorbable vascular scaffolds (BVS; Absorb™; Abbott Vascular, Santa Clara, CA, USA) implanted in overlap from distal to proximal OM1. Post-dilatation was performed with a 3.5×21 mm NC balloon. ...