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Background & aims Although Absorb Bioresorbable Vascular Scaffolds (A-BVS) are routinely used in the Asia-Pacific, there is little information on patient selection or deployment technique here. This document investigates the experiences of leading interventional cardiologists from the Asia-Pacific region with a focus on patient characteristics, deployment techniques and management. Methods and results A detailed questionnaire was distributed to 28 highly-experienced interventional cardiologists (‘Authors') from 13 Asia-Pacific countries. The results were discussed at a meeting on patient selection, technical consideration, deployment practices and patient management. Potential patient benefits of Absorb compared to metallic DES, the learning curve for patient selection and preparation, device deployment, and subsequent patient management approaches are presented. Conclusions Current practices are derived from guidelines optimized for European patients. Differences in approach exist in the Asia-Pacific context, including limited access to imaging and frequency of occurrence of complex lesions. Nevertheless, the use of the Absorb BVS (‘Absorb') in certain Asia-Pacific countries has flourished and practices here are continuing to mature.

The EVER-OCT study aimed to evaluate the degree of strut coverage, malapposition, and vessel wall response after implantation of ultra-thin (60 μm), biodegradable-polymer coated Tetrilimus everolimus-eluting stents (Sahajan and Medical Technologies Pvt. Ltd., Surat, India) by means of serial

[Figure][1] [![Graphic][3] ][3][![Graphic][4] ][4] A 42-year-old diabetic woman presented with left ventricular dysfunction late after an anterior wall myocardial infarction. Fluoro-deoxy glucose-positron emission tomography showed viability in the left anterior descending

Spontaneouscoronaryarterydissections(SCAD)haveahighnatural tendency for healing and require only temporaryscaffolding in symptomatic patients. Bio absorbable vascularscaffolds, because of their property to dissolve over time, arean attractive option for SCAD as it avoids a permanentmetallic jacket. We present a case of long segment athero-sclerotic SCAD involving ostio-proximal right coronaryartery (RCA) managed using overlapping scaffolds underoptical coherence tomography (OCT) guidance.A 55 year-old diabetic male patient with history of effortangina had a coronary angiogram (Fig. 1A & video 1) whichshowed linear filling defects suggestive of dissection involv-ing the proximal and mid RCA with TIMI III flow. OCTshowed two flaps 30 mm apart in the proximal RCA withtheproximalflap10 mmfromtheostium(Fig.1B).TheOCTimages also show evidence of intimal thickening and pla-ques suggestive of atherosclerosis. A distal landing zonewas selected at 43 mm from the ostium and was treatedusing a 3X28 mm and a 3X18 mm Absorb scaffolds (AbbottVascular, Santa Clara, CA, USA). The distal was deployedfirst followed by proximal scaffold with minimal overlapand aortic protrusion that was flared (Fig. 1C & Video 2).Postbioabsorbablevascularscaffold(BVS)OCTrunshowedgood ostial coverage and malappositions near the overlapsegment that were corrected by high pressure post dilation(Fig. 1D).Keywords Spontaneous coronary artery dissection Bio-absorbable stents Vascular scaffolds OCTOverlapping BVS Ostial BVS

80 years old male was admitted with recent history of acute coronary syndrome. Coronary angiogram showed minimal distal left main disease with significant ostial left anterior descending artery (LAD) lesion (Fig. 1A & Video 1). Optical coherence tomogram (OCT) guided percutaneous intervention (PCI) to Left main and LAD was planned using Provisional T stenting strategy. OCT evaluation showed minimal disease in distal left main (E). Ostial LAD showed thin cap fibro-atheroma with multiple calcified plaques (Fig. 1B, C & D). There was no significant calcium requiring de-bulking. Left circumflex artery (LCX) ostium showed minimal disease. After pre-dilatation and stenting of LAD lesion, there was significant plaque shift into the LCX (Fig. 1F & Video 2). Hence it was converted to two stent strategy and bifurcation stenting of LAD/LCX was done using T and protrusion technique (Fig. 1G, H & Video 3). Post stenting, left main bifurcation was assessed by OCT which showed good apposition of the stents in both LAD and LCX (Fig. 1I). Compared to IVUS OCT with lower penetration has limitations in large vessels like the left main, but its higher resolution helped in identifying a clear landing zone in the left main and a TCFA involving ostial LAD which predicted the plaque shift. Fig. 1 A: CAG in AP cranial view showing tight Ostial LAD lesion without any significant Ostial LCX disease. B: Longitudinal OCT image run from LAD to Left main (orientation-from left to right its distal to proximal) C: Cross-sectional OCT image from mid LAD ... Supplementary data related to this article can be found at http://dx.doi.org/10.1016/j.ihj.2014.08.009. The following are the supplementary data related to this article: Video 1: Initial CAG showing critical Ostial LAD disease without any significant left main or LCX disease. Click here to view.(1.1M, mp4) Video 2: After pre-dilation there was significant plaque shift into the LCX ostium. Click here to view.(1.0M, mp4) Video 3: Final angiogram after successful bifurcation PCI to LAD/LCX with two stents using TAP technique. Click here to view.(1.2M, mp4)