Bioabsorbable drug-eluting vascular scaffold for the treatment of coronary in-stent restenosis: A two center registry

Moscarella, Elisabetta; Varricchio, Attilio; Stabile, Eugenio; Franzone, Anna; Granata, Francescopaolo; Rapacciuolo, Antonio; Galasso, Gennaro; Capozzolo, Claudia; Cirillo, Plinio; Monda, Vittorio; Monterforte, Ida; Borgia, Francesco; Piro, Orlando; Bonzani, Giulio; Trimarco, Bruno; Esposito, Giovanni

doi:10.1016/j.carrev.2015.07.008

Cited by 4 publications

(1 citation statement)

References 14 publications

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“…At a mean angiographic follow-up of 9 months TLR was observed in two patients (8%) and was successfully treated with re-PCI, whereas non target vessel MI was seen in one patient (4%). In another small cohort [51], 27 patients (31 lesions) with a mean age of 63±9 and predominantly males (92%) were treated with BRS for ISR. Prevalence of diabetes was high at 40%, 78% had suffered a previous MI and 7% had undergone previous CABG.…”

Section: In-stent Restenosismentioning

confidence: 99%

Bioresorbable scaffolds for the treatment of complex lesions: are we there yet?

Panoulas

Sato

Miyazaki

et al. 2015

Interventional Cardiology

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The introduction of bioresorbable vascular scaffolds (BRS) is changing the landscape of percutaneous coronary revascularization and is considered by many the 4th revolution in interventional cardiology. To date, BRS have shown promising short-and long-term results in the treatment of simple de novo lesions. Even though the feasibility, efficacy and safety of BRS implantation for more complex lesion subsets remain unknown, reports are emerging aiming to identify the role of BRS in everyday practice. In the current review we are aiming to summarize the results from 'all-comer' BRS studies and identify strengths and limitations of BRS when tackling specific complex lesion subsets. Keywords: acute coronary syndrome • bifurcation • bioresorbable scaffold • BRS • BVS • calcific • complex • left main • ostial • outcomesThe introduction of bioresorbable vascular scaffolds (BRS) is changing the landscape of percutaneous coronary revascularization and is considered by many the 4 th revolution in interventional cardiology. The emergence of drug-eluting stents (DES) and more potent antiplatelet drugs has improved patient outcomes by reducing the incidence of restenosis and stent thrombosis [1,2]. Despite improvements in the safety profile of DES [3], late lumen loss, late stent thrombosis and permanent vessel caging are bitter reminders of the inherited limitations of inserting a foreign material in the walls of the coronary arteries. BRS are the product of the attempts to overcome these limitations by temporarily providing support to the vessel wall with a scaffold that will subsequently disappear in 2-4 years' time. Even though increases in the plaque size in the first couple of years post implantation compared with their metallic counterparts have been observed, bioresorbable scaffolds compensate by facilitating plaque regression [4] and by promoting expansive remodeling [5] at long-term follow-up. Despite the positive early experience with BRS in de novo simple lesions, the efficacy and long-term behavior of BRS implanted in complex lesions remains unknown. In recent days several real-world registries have published their early experiences with BRS and will be discussed in the current review. Bioresorbable vascular scaffolds clinical studiesThe initial experience with BRS implantation in de novo simple lesions has proven remarkable. Excellent long-term outcomes (major adverse cardiovascular events 3.4%) have been demonstrated in the 5-year follow-up of the ABSORB (Bioresorbable Everolimus Eluting Vascular Scaffold) Cohort A [6] where 30 patients with single simple de novo lesions were treated with the Absorb version v1.0. From 6-months to 2-year, the luminal dimensions in vessels treated with BRS Absorb v1.0 were increased [7] due to a decrease in plaque size without change in vessel size suggestive of positive remodeling. The Absorb v1.1 [8] multi-imaging modality study revealed unchanged late luminal loss after the first year, whereas on intravascular ultrasound (IVUS), mean lumen, scaffold, plaque and vessel area show...

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Section: In-stent Restenosismentioning

confidence: 99%