title: Stop adding metal layers: Will bioabsorbable scaffolds become the gold standard for late in-stent restenosis and neo-atherosclerosis?
abstract: The optimal management of instent restenosis has yet to be fully clarified. Drug eluting balloons are a popular strategy, but a new stent is preferred when dilatation gives a suboptimal result because of insufficient extrusion of neointimal tissue. There is concern for adding multiple permanent metallic layers to the vessel wall, especially in small vessels. The use of bioabsorbable vascular scaffolds appears an appealing alternative strategy, since it scaffolds the neointimal tissue without further adding metal struts to the vessel wall.
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton&Harefield NHS Foundation Trust, London, United Kingdom. Electronic address: idogukilic@gmail.com.
authors.forename: Ismail Dogu
authors.initials: ID
authors.lastname: Kilic
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton&Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Konstantinidis
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton&Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Michele
authors.initials: M
authors.lastname: Pighi
authors.affiliation: Interventional Cardiology Unit, Heart and Vessels Department, Careggi Hospital, Florence, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Mattesini
authors.affiliation: NIHR Biomedical Research Unit, Royal Brompton&Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
mesh_terms: D020341:Absorbable Implants; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000379:methods; D000925:Anticoagulants / Q000627:therapeutic use; D017023:Coronary Angiography / Q000379:methods; D001026:Coronary Artery Bypass / Q000009:adverse effects* / Q000379:methods; D003326:Coronary Circulation / Q000502:physiology; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008670:Metals / Q000009:adverse effects; D008875:Middle Aged; D058426:Neointima / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology; D011475:Prosthesis Failure; D019233:Retreatment; D018570:Risk Assessment; D012494:Sampling Studies; D015607:Stents / Q000009:adverse effects; D013997:Time Factors; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D014654:Vascular Patency / Q000502:physiology
chemical_list: D000925:Anticoagulants; D008670:Metals
keywords: Bioabsorbable vascular scaffold; In stent restenosis; Neoatherosclerosis