Alessio Mattesini1, Gioel G Secco2, Gianni Dall'Ara3, Matteo Ghione3, Juan C Rama-Merchan3, Alessandro Lupi4, Nicola Viceconte3, Alistair C Lindsay3, Ranil De Silva3, Nicolas Foin5, Toru Naganuma6, Serafina Valente7, Antonio Colombo6, Carlo Di Mario8. 1. NIHR Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom; Department of Heart and Vessels, AOUC Careggi, Florence, Italy. 2. NIHR Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom; Department of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara, Italy. 3. NIHR Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom. 4. Department of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara, Italy. 5. National Heart Centre Singapore, Singapore. 6. Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy. 7. Department of Heart and Vessels, AOUC Careggi, Florence, Italy. 8. NIHR Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom. Electronic address: c.dimario@rbht.nhs.uk.
Abstract
OBJECTIVES: The aim of this study was to compare the acute performance of the PLLA ABSORB bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) with second-generation metal drug-eluting stents (DES) in complex coronary artery lesions. BACKGROUND: Thick polymer-based BVS have different mechanical properties than thin second-generation DES. Data on the acute performance of BVS are limited to simple coronary lesions treated in trials with strict inclusion criteria. METHODS: Fifty complex coronary lesions (all type American College of Cardiology/American Heart Association B2-C) treated with a BVS undergoing a final optical coherence tomography (OCT) examination were compared with an equal number of matched lesions treated with second-generation DES. The following stent performance indexes were assessed with OCT: mean and minimal area, residual area stenosis (RAS), incomplete strut apposition (ISA), tissue prolapse, eccentricity index, symmetry index, strut fracture, and edge dissection. RESULTS: One hundred lesions from 73 patients were analyzed. A higher balloon diameter/reference vessel diameter ratio was used for predilation in the BVS group (p < 0.01). Most of the BVS and DES were post-dilated with short noncompliant (NC) balloons of similar diameter. OCT showed in the BVS group a higher tissue prolapse area (p = 0.08) and greater incidence of ISA at the proximal edge (p = 0.04) with no difference in the overall ISA. The RAS was 20.2% in the BVS group and 21.7% in the DES group (p = 0.32). There was no difference in the eccentricity index. The minimal and mean lumen areas were similar in the 2 groups. Two cases of strut fractures occurred after the BVS, whereas none was observed in the DES. CONCLUSIONS: Based on OCT, the BVS showed similar post-procedure area stenosis, minimal lumen area, and eccentricity index as second-generation DES. The different approach for lesion preparation and routine use of OCT guidance during BVS expansion may have contributed to these results.
OBJECTIVES: The aim of this study was to compare the acute performance of the PLLA ABSORB bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) with second-generation metal drug-eluting stents (DES) in complex coronary artery lesions. BACKGROUND: Thick polymer-based BVS have different mechanical properties than thin second-generation DES. Data on the acute performance of BVS are limited to simple coronary lesions treated in trials with strict inclusion criteria. METHODS: Fifty complex coronary lesions (all type American College of Cardiology/American Heart Association B2-C) treated with a BVS undergoing a final optical coherence tomography (OCT) examination were compared with an equal number of matched lesions treated with second-generation DES. The following stent performance indexes were assessed with OCT: mean and minimal area, residual area stenosis (RAS), incomplete strut apposition (ISA), tissue prolapse, eccentricity index, symmetry index, strut fracture, and edge dissection. RESULTS: One hundred lesions from 73 patients were analyzed. A higher balloon diameter/reference vessel diameter ratio was used for predilation in the BVS group (p < 0.01). Most of the BVS and DES were post-dilated with short noncompliant (NC) balloons of similar diameter. OCT showed in the BVS group a higher tissue prolapse area (p = 0.08) and greater incidence of ISA at the proximal edge (p = 0.04) with no difference in the overall ISA. The RAS was 20.2% in the BVS group and 21.7% in the DES group (p = 0.32). There was no difference in the eccentricity index. The minimal and mean lumen areas were similar in the 2 groups. Two cases of strut fractures occurred after the BVS, whereas none was observed in the DES. CONCLUSIONS: Based on OCT, the BVS showed similar post-procedure area stenosis, minimal lumen area, and eccentricity index as second-generation DES. The different approach for lesion preparation and routine use of OCT guidance during BVS expansion may have contributed to these results.
Authors: Guy F A Prado; Expedito E Ribeiro; Pedro H M C Melo; Fabio A Pinton; Antonio Esteves-Filho; Celso K Takimura; Jose Mariani; Luiz J Kajita; Gilberto Marchiori; Breno de Alencar Araripe Falcao; Micheli Z Galon; Paulo R Soares; Silvio Zalc; Pedro A Lemos Journal: Cardiovasc Diagn Ther Date: 2015-12
Authors: Florian Blachutzik; Niklas Boeder; Jens Wiebe; Alessio Mattesini; Oliver Dörr; Astrid Most; Timm Bauer; Jens Röther; Monique Tröbs; Christian Schlundt; Stephan Achenbach; Christian W Hamm; Holger M Nef Journal: Clin Res Cardiol Date: 2016-10-18 Impact factor: 5.460