BVS for Simple Bifurcation – A Question for Your Expert Input 

A 68 years old man had coro +/- PCI done in 12/2015. Coronary angiogram found RCA had significant bifurcation lesions as shown in (Movie 1, Movie 2). After analysis, those lesions were defined as extremely simple bifurcations. PDA can be certain that it will not close even without protect wire after stenting.

In this situation, BVS was chosen because unlike usual DES/BMS that will persist at ostium of side branches, BVS struts at ostium will disappear.

2 BVS were implanted (Movie 3). Final angiogram showed good results (Movie 4, Movie 5). Final OCT result was satisfactory and BVS struts can be seen at ostium of side branches (Movie 6).

16 months follow up coro (Movie 7, Movie 8) showed good result.
16 months follow up OCT showed full endothelialization and struts at ostium disappeared (Movie 9).

Comparison of OCT images (Figure 1).

He was MACE free and symptoms free for ~ 24 months till now.

Discussion
The potential benefit of BVS in term of absence of struts in side branch ostium in long run may offer reason for using it in patients with simple bifurcation lesions. This statement depends on the eyes of beholder and your expert opinion. It illustrated one idea 5 years ago.