Does Sirolimus-Eluting Resorbable Magnesium Scaffold Plays a Role in Iatrogenic Flow-Limiting Coronary Artery Dissection?

BACKGROUND

The third-generation sirolimus-eluting resorbable magnesium scaffold could be a competitive or alternative to a drug-eluting stent in the future, in particular in iatrogenic coronary artery dissection, to avoid unnecessary metal stents to reduce restenosis and occlusion rate.

CASE PRESENTATION: We report a 66-year-old female who presented with unstable angina. The significant medial Cx stenosis was treated with a drug-coated balloon. A small new dissection medial Cx occurred. 8 hours later, the patient developed lateral wall ST segment elevation myocardial infarction. Coronary angiography revealed Cx with iatrogenic antegrade and retrograde propagation flow limiting dissection. After dissection modification with cuttering technique, we performed IVUS-guided medial to distal Cx with Freesolve BRS. The 3-month follow-up was uneventful.

CONCLUSION

Usage of BRS in cases of iatrogenic flow limiting coronary artery dissection, especially in small diameter vessels, may be a good indication in the future to decrease the in-stent stenosis/occlusion rate. Large cohort studies are required.