title: Early (before 6 months), late (6-12 months) and very late (after 12 months) angiographic scaffold restenosis in the ABSORB Cohort B trial.
abstract: OBJECTIVE
  The long-term follow-up of the first-in-man ABSORB Cohort B trial showed that angiographic binary restenosis can occur early, late or very late after implantation of the Absorb everolimus-eluting bioresorbable vascular scaffold (Absorb BVS). Since the mechanical support of the scaffold decreases during bioresorption, the mechanism of in-segment restenosis (ISR) of the Absorb BVS might be different from that of metallic stents. The objective of the current analysis was to review the multimodality imaging of cases with binary restenosis to elucidate the mechanism of ISR after Absorb BVS implantation.
  
  
  RESULTS
  The ABSORB Cohort B trial enrolled 101 patients with a maximum of two de novo coronary lesions. At the three-year imaging and clinical follow-up, there were six cases of in-segment binary restenosis: two early ISR (<6 months), one late ISR (6-12 months) and three very late ISR (>12 months). Three of these ISR cases seemed to be induced by anatomical or procedural factors. In the other three cases, intravascular imaging (IVUS/OCT) demonstrated that the main mechanism of restenosis was significant intra-scaffold tissue growth, while the structural circularity and diameter of the scaffold were not affected.
  
  
  CONCLUSIONS
  Early and late restenosis after implantation of the Absorb bioresorbable scaffold could be related to anatomical or procedural factors. In this small cohort of patients late or very late restenosis seems to be attributed to pure intra-scaffold tissue growth without extrinsic encroachment of the scaffold.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Nakatani
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Yuki
authors.initials: Y
authors.lastname: Ishibashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Javaid
authors.initials: J
authors.lastname: Iqbal
authors.forename: Yao-Jun
authors.initials: YJ
authors.lastname: Zhang
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: John A
authors.initials: JA
authors.lastname: Ormiston
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D023921:Coronary Stenosis / Q000188:drug therapy / Q000601:surgery*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D054084:Myocardial Bridging; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation; D011446:Prospective Studies; D013997:Time Factors; D054457:Tissue Scaffolds; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional
chemical_list: D000970:Antineoplastic Agents; D000068338:Everolimus