A novel approach to treat in-stent restenosis: 6- and 12-month results using the everolimus-eluting bioresorbable vascular scaffold.
OBJECTIVE
The treatment of in-stent restenosis (ISR) remains challenging. Small case series have described successful utilisation of bioresorbable vascular scaffolds (BVS) (Absorb; Abbott Vascular, Santa Clara, CA, USA) to treat ISR. We report our experience with this novel approach.


RESULTS
Patients with ISR in native coronary arteries undergoing percutaneous coronary intervention (PCI) for ISR were treated using BVS. A total of 84 ISR lesions were treated in 65 patients. The mean age was 66±11 years, 28% had acute coronary syndrome (ACS) and 28% were diabetic. PCI was successful in all patients and all scaffolds were delivered and deployed successfully in the target lesion. All 65 patients had six-month follow-up and 49 patients had 12-month clinical follow-up. The target lesion revascularisation (TLR) rate was 3.1% at six months and 12.2% at 12 months. The mean duration from PCI to TLR was 301±148 days. No scaffold thrombosis occurred during the study period.


CONCLUSIONS
This proof of concept study demonstrates that ISR treatment utilising BVS is feasible and appears to have acceptable target lesion failure rates. Prospective randomised trials are necessary to assess whether BVS are more effective than drug-eluting stents or drug-eluting balloons to treat ISR.
Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland.
Peiman
P
Jamshidi
Tobias
T
Nyffenegger
Zaid
Z
Sabti
Elefteri
E
Buset
Stefan
S
Toggweiler
Richard
R
Kobza
Florim
F
Cuculi
D020341:Absorbable Implants; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D003324:Coronary Artery Disease / Q000628:therapy*; D023903:Coronary Restenosis / Q000628:therapy*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D013997:Time Factors
D002317:Cardiovascular Agents; D000068338:Everolimus