Background Early studies evaluating the performance of bioresorbable scaffold (BRS) Absorb in in-stent restenosis (ISR) lesions indicated promising short-term to mid-term outcomes. Aims To evaluate long-term outcomes (up to 5 years) of patients with ISR treated with the Absorb BRS. Methods We did an observational analysis of long-term outcomes of patients treated for ISR using the Absorb BRS (Abbott Vascular, Santa Clara, California, USA) between 2013 and 2016 at the Heart Centre Luzern. The main outcomes included a device-oriented composite endpoint (DOCE), defined as composite of cardiac death, target vessel (TV) myocardial infarction and TV revascularisation, target lesion revascularisation and scaffold thrombosis (ScT). Results Overall, 118 ISR lesions were treated using totally 131 BRS among 89 patients and 31 (35%) presented with an acute coronary syndrome. The median follow-up time was 66.3 (IQR 52.3–77) months. A DOCE had occurred in 17% at 1 year, 27% at 2 years and 40% at 5 years of all patients treated for ISR using Absorb. ScTs were observed in six (8.4%) of the cohort at 5 years. Conclusions Treatment of ISR using the everolimus-eluting BRS Absorb resulted in high rates of DOCE at 5 years. Interestingly, while event rates were low in the first year, there was a massive increase of DOCE between 1 and 5 years after scaffold implantation. With respect to its complexity, involving also a more unpredictable vascular healing process, current and future BRS should be used very restrictively for the treatment of ISR. All data relevant to the study are included in the article or uploaded as online supplemental information.

中文翻译：

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使用 Absorb 依维莫司洗脱生物可吸收支架治疗支架内再狭窄后的长期结果

背景 评估生物可吸收支架 (BRS) Absorb 在支架内再狭窄 (ISR) 病变中的性能的早期研究表明，短期到中期结果很有希望。目的 评估接受 Absorb BRS 治疗的 ISR 患者的长期结果（最多 5 年）。方法 我们对 2013 年至 2016 年在卢塞恩心脏中心使用 Absorb BRS（雅培血管，美国加利福尼亚州圣克拉拉）进行 ISR 治疗的患者的长期结果进行了观察性分析。主要结果包括以设备为导向的复合终点 (DOCE)，定义为心源性死亡、靶血管 (TV) 心肌梗死和 TV 血运重建、靶病变血运重建和支架血栓形成 (ScT) 的复合终点。结果 总体而言，89 名患者中的 118 处 ISR 病灶共使用 131 种 BRS 进行治疗，其中 31 名 (35%) 出现急性冠状动脉综合征。中位随访时间为 66.3 (IQR 52.3-77) 个月。在所有使用 Absorb 进行 ISR 治疗的患者中，17% 的患者在 1 年时发生了 DOCE，2 年时为 27%，5 年时为 40%。5 年时，在队列中的 6 名 (8.4%) 中观察到了 ScT。结论 使用依维莫司洗脱 BRS Absorb 治疗 ISR 导致 5 年的 DOCE 发生率很高。有趣的是，虽然第一年的事件发生率较低，但支架植入后 1 至 5 年间 DOCE 大幅增加。鉴于其复杂性，还涉及更不可预测的血管愈合过程，当前和未来的 BRS 应非常严格地用于 ISR 的治疗。