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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2017;70:543-50 - Vol. 70 Num.07 DOI: 10.1016/j.rec.2016.10.002

Restenosis After Everolimus-eluting Vascular Scaffolding. Angiographic and Optical Coherence Tomography Characterization

Jorge Chavarría a,, Javier Suárez de Lezo a, Soledad Ojeda a, Manuel Pan a, José Segura a, Francisco Mazuelos a, Simona Espejo b, José López a, Miguel Romero a, José Suárez de Lezo a

a Departamento de Cardiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain
b Departamento de Radiología, Hospital Reina Sofía, Universidad de Córdoba (IMIBIC), Córdoba, Spain

Refers to

Restenosis of Coronary Bioresorbable Vascular Scaffolds
Fernando Alfonso, Marcos García-Guimaraes
Rev Esp Cardiol. 2017;70:527-31
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Keywords

Restenosis. Everolimus-eluting vascular scaffolding. Optical coherence tomography. Neoatherosclerosis.

Abstract

Introduction and objectives

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.

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1885-5857/© 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved