We decided to treat mid LAD intermediate stenotic lesion with a bioresorbable vascular scaffold. A 7 Fr sheath was inserted through right femoral artery, and the left coronary ostium was engaged with a 7 Fr JL 4.0 catheter with side hole. Firstly, we advanced Sion blue 0.014-inch guidewire into the LAD and evaluated plaque by IVUS. IVUS-derived Minimal lumen area was 2.35mm2 and plaque burden was 73.7% (Figure 1) and the proximal to the MLA site, there was a TCFA on OCT (Figure 2). NIRS-derived lipid burden detected a max LCBI 4mm of 413. (Figure 3) The mid LAD was predilated with 2.75mm x 15mm NC balloon at 24 atm. The mid LAD was then gently dilated with 3.0mm x 28mm BVS at 7 atm ( Movie 3) for a minute and post dilated with 3.0mm x 20mm NC balloon at 28 atm up to 3.25mm. Post PCI OCT image showed good coverage with 5.6mm2 MSA. (Figure 4) Final angiogram showed that the procedure was successful ( Movie 4).
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