Acute scaffold disruption and late discontinuities

This chapter discusses acute disruption and late discontinuities of the Absorb everolimus-eluting poly-l-lactic acid (PLLA) scaffold by taking into account the availability of the ex vivo, preclinical and clinical data. To define the optical coherence tomography (OCT) image findings associated with acute disruption, a phantom study was performed to intentionally create overexpansion and acute disruption of polymeric device. The chapter summarizes the classification of OCT findings for acute disruption and late discontinuities. It presents the imaging findings of acute and subacute scaffold thrombosis, and late and very late scaffold thrombosis. In the majority of cases where the scaffold struts are well covered at an early time point, late discontinuities should be viewed as a serendipitous OCT finding of a normal bioresorption process. The discontinuities might have a pathological relationship in case of very late scaffold thrombosis.