title: Rotational Atherectomy Combined With Bioresorbable Vascular Scaffold Implantation: A Feasible Approach for Recurrent In-stent Restenosis When Other Therapies Failed.
abstract: The optimal treatment for recurrent in-stent restenosis (ISR) is uncertain. Everolimus-eluting bioresorbable vascular scaffold (BVS) use has been reported in a few cases as an interesting alternative, as it avoids long-term metal exposure to coronary circulation. Nevertheless, the underlying neointima and the multiple layers of previously implanted stents with underexpanded struts may contribute to recurrent ISR following BVS placement. We describe a feasible combined treatment for recurrent ISR in 2 patients using neointimal debulking and ablation of underexpanded stents by rotational atherectomy followed by BVS implantation. This conceptually attractive approach has not yet been reported.
authors.affiliation: Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Department of Cardiology, Rua de Santa Marta, no 50, Lisbon, Portugal 1169-024. tiagopsilva@sapo.pt.
authors.forename: Tiago
authors.initials: T
authors.lastname: Pereira-da-Silva
authors.forename: Lino
authors.initials: L
authors.lastname: Patrício
authors.forename: Rui
authors.initials: R
authors.lastname: Cruz Ferreira
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D017225:Atherectomy, Coronary / Q000379:methods*; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis / Q000601:surgery*; D023903:Coronary Restenosis / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D054855:Drug-Eluting Stents; D005240:Feasibility Studies; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D054457:Tissue Scaffolds