ABSTRACT
Another common observation is that there is often a slight ‘blown-out’ appearance (outward prolapse of the vessel wall between the stent struts) of the stented segment on OCT images, noticeable where the neointimal layer is thin. Concurrent IVUS imaging performed in these cases does not demonstrate such an appearance, which suggests that this finding is likely to be an artifact as a result of positive intraluminal pressurization from flushing of a balloon-occluded vessel. Figure 18.1 demonstrates an example of this. This patient underwent a follow-up study 12 months after implantation of a 3.0/28-mm biolimus-eluting stent in the right coronary artery (RCA) and was found to have no significant angiographic restenosis. OCT imaging showed a very thin layer of neointimal growth, and a ‘blown-out’ appearance (Figure 18.1a) that was not seen on IVUS of the equivalent segment (Figure 18.1b).
