Patients who suffer from diabetes mellitus and present coronary artery disease are at a higher risk of cardiovascular events. The coronary arteries of diabetic patients present a diffuse process of atherosclerosis with frequent distal involvement, being prone to acute cardiovascular events. Diabetics present an increased rate of developing coronary artery remodeling, negative remodeling being representative for this class of patients; this process is characterized by vessel shrinkage and an increased rate of coronary calcium accumulation that is a predictor for cardiovascular risk. Currently, it is desired to improve the treatment of diabetic patients with bioresorbable vascular scaffolds (BVS), because of their reduced risk of restenosis and the ability to restore coronary function, including vasomotion, adaptive shear stress, and expansive remodeling. Optical coherence tomography, intravascular ultrasound and multi-slice computed tomography are imaging techniques used for a high accuracy of diagnosis in coronary artery disease. This manuscript is a review that aims to highlight imaging techniques used for evaluating the functional impact of coronary lesions in diabetic patients who underwent coronary PCI with bioresorbable scaffolds and to describe the functional markers that show the specificity for predicting coronary artery disease.
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