Stephen G Ellis1, Giuseppe Steffenino2, Dean J Kereiakes3, Gregg W Stone4, R J van Geuns5, Alexandre Abizaid6, Holger Nef7, Bernardo Cortese8, Luca Testa9, Maurizio Menichelli10, Corrado Tamburino11, Tommaso Gori12, Takeshi Kimura13, Patrick W Serruys14, Salvatore Brugaletta15, Manel Sabaté15, Run-Lin Gao16. 1. Cleveland Clinic, Cleveland, Ohio. Electronic address: elliss@ccf.org. 2. Azienda Ospedaliera S. Croce e Carle, Cuneo, Italy. 3. The Christ Hospital Heart and Vascular Center and the Lindner Research Center, Cincinnati, Ohio. 4. Columbia University Medical Center, New York-Presbyterian Hospital, New York, New York. 5. Erasmus MC Rotterdam, Zuid Holland, Rotterdam, the Netherlands. 6. Instituto Dante Pazzanese de Cardiologa-Fundação, São Paulo, Brazil. 7. UKGM Universitätsklinkum Giessen, Giessen, Germany. 8. Fatebenefratelli, Milano, Italy. 9. Department of Cardiology, IRCCS Policlinico San Donato, Milano, Italy. 10. Division of Cardiology, Spaziani Hospital, Frosinone, Italy. 11. Ferrarotto Hospital-University of Catania, Catania, Italy. 12. Kardiologie I, Universitatsmedizin Mainz and DZHK Standort Rhein-Main, Germany. 13. Department of Cardiovascular Medicine at Kyoto University, Kyoto, Japan. 14. Interventional Cardiology Department of the Thoraxcenter, the Erasmus Medical Center, Rotterdam, the Netherlands. 15. Hospital Clinic, Institut Clinic Cardiovascular, Barcelona, Spain. 16. Interventional Cardiology, A.O., Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Beijing, China.
Abstract
OBJECTIVES: The authors sought to identify and verify independent correlates of device thrombosis from an analysis of multicenter trials and registries. BACKGROUND: Recent analyses suggest an increased risk of device thrombosis with Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, California) implantation compared with metallic drug-eluting stents, and data from moderate size studies suggest a risk relationship to vessel size and technique. METHODS: From 8,771 consecutively treated patients, 105 patients (1.2%) were identified with scaffold thrombosis within 1 year of implantation. They were matched 2:1 with controls selected randomly from nonthrombosis patients. Data-restricted multiple logistic analysis was used to identify significant independent covariates of the outcome. RESULTS: Early (within 1 month) scaffold thrombosis occurred in 69 patients and late (1 to 12 months) thrombosis occurred in 36 patients. Modelling found significant correlations of thrombosis to be final minimal lumen diameter <1.85 mm (odds ratio [OR]: 3.1; p = 0.004), off dual antiplatelet therapy (DAPT) status (OR: 3.1 to 3.5; p = 0.006 to 0.053), no post-dilatation with >1.1:1 balloon/scaffold ratio (OR: 2.3; p = 0.022), and reference vessel diameter <2.40 mm (OR: 2.1; p = 0.036). CONCLUSIONS: Suboptimal vessel sizing, procedural technique, angiographic outcomes, and dual antiplatelet therapy discontinuation appear to be the principal determinants of Absorb scaffold thrombosis risk through 12 months after implantation.
OBJECTIVES: The authors sought to identify and verify independent correlates of device thrombosis from an analysis of multicenter trials and registries. BACKGROUND: Recent analyses suggest an increased risk of device thrombosis with Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, California) implantation compared with metallic drug-eluting stents, and data from moderate size studies suggest a risk relationship to vessel size and technique. METHODS: From 8,771 consecutively treated patients, 105 patients (1.2%) were identified with scaffold thrombosis within 1 year of implantation. They were matched 2:1 with controls selected randomly from nonthrombosis patients. Data-restricted multiple logistic analysis was used to identify significant independent covariates of the outcome. RESULTS: Early (within 1 month) scaffold thrombosis occurred in 69 patients and late (1 to 12 months) thrombosis occurred in 36 patients. Modelling found significant correlations of thrombosis to be final minimal lumen diameter <1.85 mm (odds ratio [OR]: 3.1; p = 0.004), off dual antiplatelet therapy (DAPT) status (OR: 3.1 to 3.5; p = 0.006 to 0.053), no post-dilatation with >1.1:1 balloon/scaffold ratio (OR: 2.3; p = 0.022), and reference vessel diameter <2.40 mm (OR: 2.1; p = 0.036). CONCLUSIONS: Suboptimal vessel sizing, procedural technique, angiographic outcomes, and dual antiplatelet therapy discontinuation appear to be the principal determinants of Absorb scaffold thrombosis risk through 12 months after implantation.
Authors: Lukasz Koltowski; Mariusz Tomaniak; Lisa Gross; Bartosz Rymuza; Michal Kowara; Radoslaw Parma; Anna Komosa; Mariusz Klopotowski; Claudius Jacobshagen; Tommaso Gori; Daniel Aradi; Kurt Huber; Martin Hadamitzky; Steffen Massberg; Maciej Lesiak; Krzysztof J Filipiak; Adam Witkowski; Grzegorz Opolski; Zenon Huczek; Dirk Sibbing Journal: J Thromb Thrombolysis Date: 2019-04 Impact factor: 2.300
Authors: Xiang Wang; Xinxin Chen; Tao Tian; Hongzhao You; Yulin Li; Muli Wu; Xiaoyu Du; He Cai; Yang Zheng; Jie Du Journal: Sci Rep Date: 2020-04-14 Impact factor: 4.379