Vol 30, No 4 (2023)
Image in Cardiovascular Medicine
Published online: 2023-09-07

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INTERVENTIONAL CARDIOLOGY

IMAGE IN CARDIOVASCULAR MEDICINE

Cardiology Journal

2023, Vol. 30, No. 4, 671–672

DOI: 10.5603/cj.85511

Copyright © 2023 Via Medica

ISSN 1897–5593

eISSN 1898–018X

Vasomotor function and optical coherence tomography follow-up 4 years after Fantom bioresorbable scaffold implantation: A case report

Łukasz KołtowskiMartyna ZaleskaJakub MaksymJanusz Kochman
First Chair and Department of Cardiology, Warsaw Medical University, Warsaw, Poland

Address for correspondence: Łukasz Kołtowski, MD, PhD, First Chair and Department of Cardiology, Medical University of Warsaw, ul. Banacha 1a, 02097 Warszawa, Poland, tel: +48 501 418 951, e-mail: lukasz@koltowski.com

Received: 24.08.2021 Accepted: 1.12.2021

This article is available in open access under Creative Common Attribution-Non-Commercial-No Derivatives 4.0 International (CC BY-NC-ND 4.0) license, allowing to download articles and share them with others as long as they credit the authors and the publisher, but without permission to change them in any way or use them commercially.

A 64-year-old hypertensive male patient with type 2 diabetes mellitus and dyslipidemia underwent percutaneous coronary intervention (PCI) of mid left anterior descending artery (LAD) stenosis with implantation of the Fantom bioresorbable vascular scaffold (BRS) 3.0 × 18 mm (Reva Medical, San Diego, CA, USA) due to a chronic coronary symptom. Seven months later he had anterior ST-segment elevation myocardial infarction and was successfully treated with PCI of the left main and proximal LAD with two Xience drug eluting stents 4.0 × 15 mm and 3.0 × 28 mm (Abbott Vascular). Prespecified 48-month follow-up coronary angiography and optical coherence tomography (OCT) showed preserved vessel patency with a 90% absorption of scaffold in the mid LAD without neoatherosclerosis signs and neointimal coverage of metallic stent struts in the proximal LAD. After the first OCT pullback, a bolus of nitroglycerin was administered intracoronary to assess the vasodilatory response. In the scaffolded region, a 21% increase of the mean lumen area (from 3.69 mm2 to 4.40 mm2) was detected. There was no change in lumen areas in the region of the metallic stenting (5.55 mm2 and 5.54 mm2) (Fig. 1).

Figure 1. Optical coherence tomography with angiography co-registration 48-month after Fantom bioresorbable scaffold implantation in the mid left anterior descending (A, C) and Xience drug eluting stents in the left main and proximal anterior descending artery (B, D). Measurement before (A, B) and after (C, D) intracoronary nitroglycerin administration. The provided measures are the minimum lumen areas.

Fantom is a next-generation radiopaque sirolimus-eluting bioresorbable scaffold made from tyrosine-derived polymer with a strut thickness of 125 μm. The restoration of vasomotor function with homogenous neointima in the long-term follow-up is promising for development of a new generation of BRS.

According to available research, the presented case is the first which describes outcomes 4 years after a Fantom BRS implantation. While results are promising, larger studies with long-term follow-up are required to confirm these results.

Conflict of interest: None declared