The Official Journal of EuroPCR and the European Association of Percutaneous Coronary Interventions (EAPCI)

Reply to the letter to the editor

Bioresorbable vascular scaffolds for recurrent in-stent restenosis

EuroIntervention 2016;11:1448. DOI: 10.4244/EIJV11I12A280

Department of Cardiology, Hospital Universitario de La Princesa Madrid, Instituto de Investigación Sanitaria IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain

We sincerely appreciate the interest of Piraino et al in our paper1 describing the occurrence of subacute bioresorbable vascular scaffold (BVS) thrombosis in a very old patient with recurrent in-stent restenosis (R-ISR) in a heavily calcified vessel. We fully agree with their concerns regarding the importance of final result optimisation in patients with “recalcitrant” in-stent restenosis (ISR)2,3. In this setting, characterised by the classic “metallic onion skin” underlying substrate, tackling any residual resistant underexpansion is of paramount importance2,3. Likewise, the strategy of “leave nothing behind” is especially appealing in this challenging patient subset with multiple metal layers. Certainly, drug-coated ...

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