Pereira-da-Silva Tiago, Patrício Lino, Cruz Ferreira Rui
Hospital de Santa Marta, Centro Hospitalar de Lisboa Central, Department of Cardiology, Rua de Santa Marta, no 50, Lisbon, Portugal 1169-024.
J Invasive Cardiol. 2015 Jul;27(7):E143-5.
The optimal treatment for recurrent in-stent restenosis (ISR) is uncertain. Everolimus-eluting bioresorbable vascular scaffold (BVS) use has been reported in a few cases as an interesting alternative, as it avoids long-term metal exposure to coronary circulation. Nevertheless, the underlying neointima and the multiple layers of previously implanted stents with underexpanded struts may contribute to recurrent ISR following BVS placement. We describe a feasible combined treatment for recurrent ISR in 2 patients using neointimal debulking and ablation of underexpanded stents by rotational atherectomy followed by BVS implantation. This conceptually attractive approach has not yet been reported.
复发性支架内再狭窄（ISR）的最佳治疗方法尚不确定。有少数病例报道使用依维莫司洗脱生物可吸收血管支架（BVS）是一种有趣的替代方法，因为它避免了金属长期暴露于冠状动脉循环中。然而，潜在的新生内膜以及先前植入的带有未充分扩张支架小梁的多层支架可能会导致BVS置入后复发性ISR。我们描述了一种针对2例复发性ISR患者的可行联合治疗方法，即通过旋磨术对新生内膜进行减容并消融未充分扩张的支架，随后植入BVS。这种在概念上颇具吸引力的方法尚未见报道。
