Carlos M Campos1, Hector M Garcia-Garcia2, Takashi Muramatsu3, Pedro de Araujo Gonçalves4, Yoshinobu Onuma5, Dariusz Dudek6, Leif Thuesen7, Mark W I Webster8, Pieter Kitslaar9, Susan Veldhof10, Johan H C Reiber9, Koen Nieman11, John A Ormiston8, Patrick W Serruys12. 1. Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands; Heart Institute (InCor), University of São Paulo Medical School, Sao Paulo, Brazil; Department of Interventional Cardiology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil. 2. Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands. Electronic address: hect2701@gmail.com. 3. Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands; Department of Cardiology, Fujita Health University Hospital, Toyoake, Japan. 4. Cardiology Department, Hospital de Santa Cruz, CHLO, Lisbon, Portugal; Hospital da Luz, Cardiovascular Center, ESS, Lisbon, Portugal; CEDOC, Chronic Diseases Research Center, FCM-NOVA, Lisbon, Portugal. 5. Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands. 6. Jagiellonian University, Krakow, Poland. 7. Department of Cardiology, Aarhus University Hospital, Skejby, Denmark. 8. Auckland City Hospital, Auckland, New Zealand. 9. Medis Medical Imaging Systems, B.V., Leiden, The Netherlands; Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. 10. Abbott Vascular, Diegem, Belgium. 11. Department of Cardiology, Erasmus University Medical Centre, Thoraxcenter, Rotterdam, The Netherlands; Department of Radiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. 12. International Centre for Circulatory Health, NHLI, Imperial College London, London, United Kingdom.
Abstract
INTRODUCTION AND OBJECTIVES: The Absorb bioresorbable vascular scaffold has been shown to decrease total plaque areas in the treated segment. However, it is unknown whether plaque size is modified in scaffolded segments only or whether the modification extends to other coronary segments. METHODS: Absorb Cohort A is a single-arm, prospective study, with safety and imaging endpoints, in which 30 patients underwent percutaneous coronary intervention with the first generation Absorb bioresorbable vascular scaffold. Noninvasive multislice computed tomography imaging was performed in 18 patients at 18 months and 5 years of follow-up. The present study was an intrapatient comparison of matched segments (normalized by the segment length) of the scaffolded region with nonintervened segments for lumen volume, vessel volume, plaque volume, plaque burden, and percent change in plaque atheroma volume. RESULTS: All 18 scaffolded segments could be analyzed. In the nonintervened segments, 1 of 72 segments had a motion artifact and was excluded. Serial comparison showed that the scaffolded segments showed no significant change in the mean plaque burden, total atheroma volume, total lumen volume, or vessel volume between 18 months and 5 years. Conversely, the untreated segments showed a significant increase in plaque burden (2.7 ± 6.5%; P < .01) and normalized plaque volumes (8.0 ± 22.8mm(3); P < .01). This resulted in a significant difference in plaque burden between scaffolded and nonintervened segments (P = .03). CONCLUSIONS: In this small series, the Absorb bioresorbable vascular scaffold showed the potential to provide an additional benefit to pharmacological therapy in locally reducing progression of percent plaque burden. These findings need to be confirmed in larger studies.
INTRODUCTION AND OBJECTIVES: The Absorb bioresorbable vascular scaffold has been shown to decrease total plaque areas in the treated segment. However, it is unknown whether plaque size is modified in scaffolded segments only or whether the modification extends to other coronary segments. METHODS: Absorb Cohort A is a single-arm, prospective study, with safety and imaging endpoints, in which 30 patients underwent percutaneous coronary intervention with the first generation Absorb bioresorbable vascular scaffold. Noninvasive multislice computed tomography imaging was performed in 18 patients at 18 months and 5 years of follow-up. The present study was an intrapatient comparison of matched segments (normalized by the segment length) of the scaffolded region with nonintervened segments for lumen volume, vessel volume, plaque volume, plaque burden, and percent change in plaque atheroma volume. RESULTS: All 18 scaffolded segments could be analyzed. In the nonintervened segments, 1 of 72 segments had a motion artifact and was excluded. Serial comparison showed that the scaffolded segments showed no significant change in the mean plaque burden, total atheroma volume, total lumen volume, or vessel volume between 18 months and 5 years. Conversely, the untreated segments showed a significant increase in plaque burden (2.7 ± 6.5%; P < .01) and normalized plaque volumes (8.0 ± 22.8mm(3); P < .01). This resulted in a significant difference in plaque burden between scaffolded and nonintervened segments (P = .03). CONCLUSIONS: In this small series, the Absorb bioresorbable vascular scaffold showed the potential to provide an additional benefit to pharmacological therapy in locally reducing progression of percent plaque burden. These findings need to be confirmed in larger studies.