Author + information
- Elisabetta Moscarella1,
- Alfonso Ielasi2,
- Maria Carmen De Angelis3,
- Bernardo Cortese4,
- Sebastian Coscarelli5,
- Akihito Tanaka6,
- Azeem Latib7,
- Maurizio Tespili2 and
- Attilio Varricchio3
- 1Second University of Naples AO Dei Colli, Italy
- 2Bolognini Hospital Seriate, Italy
- 3Ospedale Santa Maria della Pieta Nola, Italy
- 4Fatebenefratelli Hospital, Milan, Italy
- 5Cardiovascular Intervention Unit, San Martino Hospital, Belluno, Italy, Italy
- 6San Raffaele Hospital, Milan, Italy
- 7EMO GVM Centro Cuore Columbus, San Raffaele Hospital, Italy
Even if drug eluting stent have significantly reduced the rate of in-stent restenosis (ISR) compared to bare metal stent, ISR still exists and treatment is still challenging. In this setting the use of bioresorbable vascular scaffold (BVS) appears very attractive as it allows drug delivery combined with transient vessel scaffolding thus obviating the limitations of Drug-eluting stent or balloon as ISR therapy. We aimed to investigate the Long-term results following BVS use in ISR lesions.
A prospective analysis was performed on all patients that underwent percutaneous coronary intervention (PCI) with BVS implantation for ISR at 7 Italian Centers. Primary endpoint was the device-oriented composite end-point (DOCE: Cardiac death, target vessel myocardial infarction –TV-MI-, ischemia-driven target lesion revascularization–ID-TLR-) at the longest follow-up available.
From April 2012 to June 2014, a total of 116 patients (127 lesions) underwent PCI for ISR with BVS implantation. Among the ISR lesions, the majority was DES (78, 61.6%), de novo (92, 72.4%) ISR and 81(63.8%) were diffuse-ISR. Procedural success was achieved for all (100%) patients. No in-hospital death, myocardial infarction, or revascularization occurred. At median follow up time of 20 months (IQ 15-24), 14 (12.1%) ID-TLR occurred, 3 (2.6%) target vessel MI and 6 (5.2%) cardiovascular death occurred. DOCE occurred in 17 (14.7%) patients. Definite/probable scaffold thrombosis occurred in 2 (1.7%) patients.
To the best of our knowledge we report the largest registry with the longest follow up available on the use of BVS for ISR treatment. Our registry suggests that the use of BVS implantation for the treatment of complex DES and BMS ISR lesions might be associated with acceptable long-term clinical outcomes.