ABSTRACT
Bioresorbable vascular scaffolds (BVSs) have been shown effective as metallic drug-eluting stents in the treatment of patients with coronary artery disease. The use of intravascular imaging techniques is not necessary in noncomplex cases in the hands of experienced operators. However, both intravascular ultrasound (IVUS) and optical coherence tomography (OCT), are advisable in the initial experiences with this device and in complex cases. IVUS allows the assessment of the vessel wall dynamics and the bioresorption process and OCT provides an accurate assessment of the scaffold characteristics and bioresorption. Coronary chronic total occlusions (CTO) successfully treated with stent implantation has been associated with dynamic changes of the occluded vessel, such as lumen enlargement, that can predispose to late-acquired malapposition. Bifurcation lesions with side-branch jailing are also associated with persistent nonapposed struts. The chapter shows the potential utility of IVUS and OCT in complex percutaneous coronary interventions.
