title: Restenosis After Everolimus-eluting Vascular Scaffolding. Angiographic and Optical Coherence Tomography Characterization.
abstract: OBJECTIVE
  Coronary restenosis after bioresorbable vascular scaffold (BVS) implantation is infrequent and little information is available on the main characteristics of these lesions. The aim of this study was to assess restenotic lesions by using optical coherence tomography (OCT).
  
  
  METHODS
  We studied 330 patients with coronary artery disease who received 398 BVS to treat 380 lesions. These patients were clinically and angiographically evaluated at follow-up and OCT was carried out on detection of restenosis.
  
  
  RESULTS
  After a follow-up of 19 ± 10 months, 18 restenotic lesions were detected in 17 patients (5.4%). Depending on the time of presentation, most cases of restenosis were late or very late (9 ± 4 months). The most frequent angiographic pattern was focal restenosis in 12 (67%) patients, which was mainly located at the proximal border in 9 (75%) whether involving the scaffold or not. The homogeneous pattern was infrequent, occurring in 3 (25%) lesions and was only visualized in 3 out of 6 cases of restenosis located at the margin. When the focal restenosis was located in the platform, OCT showed a heterogeneous or layered pattern. Finally, diffuse restenosis was observed in 6 patients (33%). In diffuse restenosis, OCT revealed a lipid-laden or layered tissue structure and the presence of microvessels or microcalcification, potentially suggesting a neoatherosclerotic process.
  
  
  CONCLUSIONS
  After a mean follow-up of 19 months, the restenosis rate was 5.4%. Most restenotic lesions were focal, located at the proximal border. Diffuse restenosis mostly occurred late or very late and most showed signs suggestive of neoatherosclerosis.
authors.affiliation: Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain. Electronic address: jorgechv@yahoo.com.
authors.forename: Jorge
authors.initials: J
authors.lastname: Chavarría
authors.affiliation: Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Suárez de Lezo
authors.affiliation: Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Soledad
authors.initials: S
authors.lastname: Ojeda
authors.affiliation: Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: Pan
authors.affiliation: Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Segura
authors.affiliation: Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Mazuelos
authors.affiliation: Departamento de Radiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Simona
authors.initials: S
authors.lastname: Espejo
authors.affiliation: Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: José
authors.initials: J
authors.lastname: López
authors.affiliation: Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: Miguel
authors.initials: M
authors.lastname: Romero
authors.affiliation: Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Suárez de Lezo
mesh_terms: D017023:Coronary Angiography / Q000379:methods; D023903:Coronary Restenosis / Q000175:diagnosis*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D013997:Time Factors; D054457:Tissue Scaffolds / Q000009:adverse effects*; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus
keywords: Armazón vascular liberador de everolimus; Everolimus-eluting vascular scaffolding; Neoateroesclerosis; Neoatherosclerosis; Optical coherence tomography; Reestenosis; Restenosis; Tomografía de coherencia óptica