Bioresorbable Everolimus-Eluting Vascular Scaffold for Long Coronary Lesions: A Subanalysis of the International, Multicenter GHOST-EU Registry

Salvatore Geraci, Hiroyoshi Kawamoto, Giuseppe Caramanno, Neil Ruparelia, Davide Capodanno, Salvatore Brugaletta, Tommaso Gori, Holger Nef, Manel Sabate, Julinda Mehilli, Maciej Lesiak, Christoph Naber, Carlo Di Mario, Piera Capranzano, Jens Wiebe, Aleksander Araszkiewicz, Stelios Pyxaras, Alessio Mattesini, Thomas Münzel, Corrado TamburinoAntonio Colombo, Azeem Latib

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objectives The authors sought to investigate 1-year outcomes in patients treated with bioresorbable everolimus-eluting vascular scaffolds (BVS) for “long coronary lesions.” Background The present substudy derived from the GHOST-EU registry included 1,722 lesions in 1,468 consecutive patients, enrolled between November 2011 and September 2014 at 11 European centers. Methods The lesions were divided into 3 groups according to continuous BVS length: 1) shorter than 30 mm; 2) between 30 and 60 mm; and 3) longer than 60 mm. Primary device-oriented endpoint (target lesion failure [TLF]) was defined as a combination of cardiovascular death, target vessel myocardial infarction, or clinically driven target lesion revascularization. Results Patients with lesions ≥60 mm had more comorbidities and more complex lesion characteristics, including chronic total occlusions (37%), bifurcation lesions (40.3%), higher Syntax score (16.4 ± 7.8), and higher number of scaffolds implanted per lesion (3.3 ± 0.9 mm). The main target vessel was the left anterior coronary artery in all groups. Median follow-up was 384 (interquartile range: 359 to 459) days. One-year follow-up was completed in 70.3% of patients. TLF at 1 year was significantly higher in group C (group A 4.8%, group B 4.5%, group C 14.3%; overall p = 0.001), whereas there were no significant differences between groups A and B. Finally, a numerically higher (but not statistically significant) number of scaffold thromboses were observed in group C when compared with shorter lesions (group A 2.1%, group B 1.1%, group C 3.8%; overall p = 0.29). Conclusions In a real-world setting, treatment of long coronary lesions with BVS ≥60 mm was associated with a higher TLF rate, driven by myocardial infarction and clinically driven target lesion revascularization.

Original languageEnglish (US)
Pages (from-to)560-568
Number of pages9
JournalJACC: Cardiovascular Interventions
Volume10
Issue number6
DOIs
StatePublished - Mar 27 2017
Externally publishedYes

Keywords

  • bioresorbable vascular scaffolds
  • complex coronary lesions
  • long coronary lesions
  • vascular reparative therapy

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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