Case1: A 50’syear-old male was diagnosed of STEMI and PCI was performed for RCA with stent (RCA#1: 3^rd generation EES, #2: Biolimus-A9 coated stent). 5months later, CAG with coronary angioscopy was performed. Case2: A 60’s year-old female who had been performed PCI for LAD#7 with 3^rdgeneration-EES 4 months ago was diagnosed effort angina pectoris and PCI was performed for LMT–LAD#6 with Biolimus-A9 coated stent. 35 days later, CAG with coronary angioscopy was performed. 

Case1: electrocardiogram showed Q wave in ⅡⅢaVF, and Ultrasoundcardiography showed no asynergy. Case2: electrocardiogram showed ST depression in ⅡⅢaVF V4-6 and poor R progression in V1-3. Ultrasoundcardiography showed no asynergy.

Case1: CAG showed acute occlusion of RCA#2. We put Biolimus-A9 coated stent for RCA#2, and 3rd generation EES for RCA#1 in addition because of vessel dissection. 5 months later, follow up CAG with coronary angioscopy was performed. Case2: 3rdgeneration-EES was deployed to LAD#7 4 months ago. We put Biolimus-A9 coated stent for LM-LAD#6 at the procedure, and follow up CAG with coronary angioscopy was performed 35 days later.

We report 2 cases observed by coronary angioscopy. Coronary angioscopy evaluates the degree of neointimal coverage (NIC) after stent implantation, and NIC is classified into 4 grades. Grade0: stent struts fully visible, similar to immediately after implantation. Grade1: stent struts bulging into the lumen,although covered, still transparently visible. Grade2: stent struts embedded in the neointima, but translucently visible. Grade3: stent struts fully embedded and invisible on Coronary angioscopy. Biolimus-A9 coated stent has unique concept compared to other drug-eluting stent, including polymer-free, earlier drug release system within 30 days. Although the stent changes to drug-free status in early phase, Biolims-A9 can keep the drug effect over along term due to its high lipid solubility. These characteristics are expected to result in earlier acquisition of NIC after stent implantation. Case1: 3^rd G-EES had struts with low NIC grade(Grade:1), and Biolimus-A9 coated stent had struts with higher NIC grade (Grade:2) than 3^rd G-EES. Case2: 3^rd G-EES implanted 5 months before had struts with low NIC grade (Grade:0), and Biolimus-A9 coated stent implanted 35 days before had struts with higher NIC grade (Grade:1) than 3^rd G-EES.

There are no reports which observe the neointimal coverage of Biolimus-A9 coated stent by coronary angioscopy  in early phase. Both cases show the earlier acquisition of neointimal coverage, and the potential for improving delayed arterial healing after Biolimus-A9 coated stent deployment.