Restenosis of bioreasorbable stent is mostly due to an uncorrect evaluation of lesion before scaffold implantation

We analyzed first 30 parients treated with Magmaris bioreasorbable stent implantation for de novo coronary lesions.

Fourteen patients were re-admitted and underwent an angiographic evaluation; in six the angiography showed a severe in-scaffold or in segment restenosis treated with a DES implantation in two cases, with DCB in three and with a second BVS in one.

Analyzing these procedures we found multiple mistakes in the evaluation of lesions and in the performing the procedure.

Case 1: there were few calcifications in the site of lesion but the mistake was the evaluation of lenght of lesion that was not enterely covered with the scaffold infact after ten months another stent was left proximally.

Case 2: post dilatation not performed with an oversized NC balloon at high atmosphere but a 1:1 balloon was used

Case 3: probably the worst case; the presence of a bifurcation and the quantity of calcium was not considered before Magmaris implantation; the restenosis was subocclusive and occurred at one month for rest angina

Case 4: no mistake was found in the evaluation of lesion and in the different step of procedure, everything was done according general recomandations

Case 5: post dilatation not performed with an oversized NC balloon at high atmosphere but with a 1:1 balloon

Case 6: initial lesion was too calcified, even if well performed, after one month a focal in-scaffold restenosis occurred.

In conclusion in three cases we failed the evaluation, in two almost one procedural step.

Four cases occurred at beginning of our experience, at the moment we don’t have any serious clinical adverse event.

The evaluation of lesions seems to be crucial.