Bioresorbable Vascular Scaffolds

This chapter presents important guiding strategies for optimal Bioresorbable Vascular Scaffold (BVS) implantation. Intracoronary nitroglycerin injection is highly recommended in order to avoid BVS undersizing due to chronic distal arterial spasm. The routine use of a high-pressure non-compliant post-dilatation balloon is strongly recommended. Use of a post-dilatation balloon that is slightly larger than the selected BVS can result in adequate scaffold expansion. The use of BVS in bifurcation lesions has the advantage of avoiding long-term jailing of the side branch. In a one-scaffold strategy (provisional scaffolding), only the main vessel is treated with BVS implantation. The main strategies are meticulous lesion preparation and pre-dilatation with non-compliant balloons with a nominal size equal to the intended BVS and inflated at high pressure. The T-stenting technique provides a good solution in a case of bifurcation with an angle close to 90 degrees.