CLINICAL RESEARCH CORONARY INTERVENTIONS 1320 EuroIntervention 2017;13: 1320-1327 published online June 2017 DOI: 10.4244/EIJ-D-17-00291 © Europa Digital & Publishing 2017. All rights reserved. *Corresponding author: Department of Cardiology, Munich University Clinic, Marchioninistr. 15, 81377 Munich, Germany. E-mail: Julinda.Mehilli@med.uni-muenchen.de Clinical restenosis and its predictors after implantation of everolimus-eluting bioresorbable vascular scaffolds: results from GABI-R Julinda Mehilli 1,2 *, MD; Stephan Achenbach 3 , MD; Jochen Wöhrle 4 , MD; Morritz Baquet 1 , MD; Thomas Riemer 5 , PhD; Thomas Münzel 6,7 , MD; Holger M. Nef 8 , MD; Christoph Naber 9 , MD; Gert Richardt 10 , MD; Ralf Zahn 11 , MD; Tommaso Gori 6,7 , MD; Till Neumann 12 , MD, PhD; Johannes Kastner 13 , MD; Axel Schmermund 14 , MD; Christian Hamm 8,15 , MD; for the GABI-R Study Group 1. Department of Cardiology, Munich University Clinic, LMU, Munich, Germany; 2. German Centre for Cardiovascular Research, partner site Munich Heart Alliance, Munich, Germany; 3. Department of Cardiology, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany; 4. Department of Internal Medicine II, University of Ulm, Ulm, Germany; 5. IHF GmbH - Institut für Herzinfarktforschung, Ludwigshafen, Germany; 6. Zentrum für Kardiologie, University Medical Center, Johannes Gutenberg University Mainz, Mainz, Germany; 7. German Centre for Cardiovascular Research, partner site Rhine Main, Mainz, Germany; 8. Medizinische Klinik I, Department of Cardiology, University of Giessen, Giessen, Germany; 9. Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany; 10. Herzzentrum, Segeberger Kliniken GmbH, Bad Segeberg, Germany; 11. Abteilung für Kardiologie, Herzzentrum Ludwigshafen, Ludwigshafen, Germany; 12. Department of Cardiology, University of Essen, Essen, Germany; 13. Department of Cardiology, University of Vienna Medical School, Vienna, Austria; 14. Bethanien Hospital, Frankfurt, Germany; 15. Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany Abstract Aims: The aim of this study was to assess clinical restenosis and its predictors after implantation of bioresorbable vascular scaffolds (BVS) in everyday practice in the large-scale German-Austrian ABSORB Registry (GABI-R). Methods and results: Between November 2013 and January 2016, 3,264 patients underwent BVS implan- tation in the 93 centres of GABI-R (ClinicalTrials.gov NCT02066623). At six-month follow-up, 24 patients experienced clinically indicated target lesion revascularisation (cTLR) unrelated to BVS thrombosis (cumu- lative incidence 0.76%; angiographically, 58.3% of in-BVS restenosis of focal pattern). Compared to patients without cTLR, patients with cTLR had more lesions per patient (1.83±1.0 vs. 1.36±0.7), complex (52.3% vs. 36.2%) and mild-to-moderately calcified lesions (65.9% vs. 60.5%) treated, and more frequently had overlapping BVS (22.2% vs. 10.8%), all p<0.05. Implanted BVS length was 40.0 mm (28.0, 46.9) vs. 23.0 mm (18.0, 30.0), p<0.001, remaining in the multivariable analysis the only independent predictor of cTLR (hazard ratio 1.02, 95% CI: 1.01-1.04, p<0.001). The myocardial infarction rate was also signi- ficantly higher among patients with cTLR, 29.2% vs. 1.7%, p<0.0001. Conclusions: cTLR related to BVS restenosis at six months after BVS implantation is a rare event depend- ing on implanted BVS length. Whether cTLR increases the myocardial infarction risk needs to be evaluated at longer-term follow-up and within the setting of adequately powered randomised trials. KEYWORDS • bioresorbable scaffolds • in-stent restenosis • stent thrombosis SUBMITTED ON 09/04/2017 - REVISION RECEIVED ON 1 st 05/05/2017 / 2 nd 13/06/2017 - ACCEPTED ON 23/06/2017