J INVASIVE CARDIOL 2020;32(5):E136-E137.
Key words: angiography, cardiac imaging, non-contrast CT, radiopaque markers
A 39-year-old diabetic, hypertensive male presented with chronic stable angina class II, with a positive exercise treadmill test. His clinical examination was unremarkable. Two-dimensional echocardiography revealed no regional wall-motion abnormality and left ventricular ejection fraction of 60%. Coronary angiography revealed 90% tubular bifurcation lesion (Medina 1,0,0) of the mid left anterior descending (LAD) (Figure 1A) and 80% tubular lesion of the mid right coronary artery (RCA) (Figure 2A). A 3.5 x 28 mm Absorb bioresorbable vascular scaffold (Abbott Vascular) was deployed across the mid LAD, followed by final kissing-balloon inflation between the LAD and first diagonal (D1). A 3.5 x 28 mm Absorb BVS was deployed across the mid RCA. Both arteries had TIMI 3 flow and no angiographic residual stenosis (Figures 1B and 2B). The patient remained asymptomatic during regular follow-up visits. A 128-slice dual-source computed tomography coronary angiogram (CTCA) at 5-year follow-up exam showed normal caliber and flow across the LAD and RCA (Figures 1C and 2C). As the Absorb BVS does not have an artifact on CTCA (like metallic stents), the extent/location of the stent in situ can only be assessed by localizing the proximal and distal radiopaque platinum markers in a non-contrast CTCA. The two markers on each stent are visualized as radiopaque dots at the proximal and distal ends of the BVS, across the intervened coronary arteries (Figures 1D and 2D). This characteristic appearance of BVS on CTCA should be interpreted as the footprint of a disappeared BVS, instead of a calcified plaque.
From the Departments of 1Cardiology and 2Radiodiagnosis, Advanced Cardiac Centre, Post Graduate Institute of Medical Education & Research, Chandigarh, India.
Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein.
The authors report that patient consent was provided for publication of the images used herein.
Manuscript accepted July 24, 2019.
Address for correspondence: Prof (Dr) Rajesh Vijayvergiya, MD, DM, FSCAI, FISES, FACC, Department of Cardiology, Advanced Cardiac Centre, Post Graduate Institute of Medical Education & Research, Sector 12, Chandigarh–160 012, India. Email: email@example.com