Bioresorbable vascular scaffold (BVS) for in-stent chronic total occlusion: Antegrade recanalization and IVUS-guided BVS implantation by radial access.

The completely absorbable stents represent one of the latest innovations in the field of interventional cardiology, prospecting the possibility of "vascular repair". In the published trials (ABSORB Cohort A and B, ABSORB EXTEND, and ABSORB II, III and IV) chronic total occlusions (CTOs) were considered an exclusion criteria. More recently the CTO-ABSORB pilot study demonstrated the safety and feasibility of bioresorbable vascular scaffold (BVS) use in case of CTO recanalization. We present the first case, to our knowledge, of in-stent occlusion successfully treated with an everolimus-eluting BVS and discuss its potential advantages in such kind of lesions.

[Infective complications in patients with implantable cardiac devices: catheter extraction]. / Complicanze infettive nel paziente portatore di dispositivi: l'estrazione di elettrocateteri.

Complications related to device implantation, such as infections and malfunction, play a major role when considering the increasing rate of implant procedures. It is widely accepted in the scientific literature that the most effective way to eradicate device-related infections or complications resulting from malfunctioning involves the complete removal of the pacing system. The techniques of transvenous lead extraction include manual traction, mechanical dilation, powered sheaths (excimer laser system) using the femoral, jugular/subclavian or hybrid approach. The possibility of using different approaches, even in combination, has broadened the therapeutic armamentarium, allowing to revise the indications for removal of the system. Further clinical studies relating, specifically, to the different extraction techniques may contribute to develop common protocols by also evaluating the cost-effectiveness of the methods available.