TY - JOUR
T1 - Bioresorbable vascular scaffold with optimized implantation technique
T2 - Long-term outcomes from a single-center experience
AU - Albani, Stefano
AU - Giannini, Francesco
AU - Mitomo, Satoru
AU - Fabris, Enrico
AU - Mangieri, Antonio
AU - Ponticelli, Francesco
AU - Khokhar, Arif A.
AU - Toselli, Marco
AU - Latib, Azeem
AU - Colombo, Antonio
N1 - Publisher Copyright:
© 2021 HMP Communications. All rights reserved.
PY - 2021/2
Y1 - 2021/2
N2 - Background. Previous randomized controlled trials demonstrated a higher rate of stent thrombosis with bioresorbable vascular scaffold (BVS) implantation as compared with second-generation drug-eluting stent in selected patients/lesions. However, long-term outcomes of BVS implantations that utilize an optimized technique (OIT) in unselected patients/lesions are lacking. The aim of this study was to assess the real-world, long-term clinical outcomes of BVS (Absorb; Abbott Vascular) with OIT. Methods and Results. In a cohort of 156 patients, a total of 347 BVS devices (435 lesions) were implanted, with intravascular ultrasound (IVUS) guidance utilized in 303 (87.3%) of the scaffolds. The primary efficacy endpoint was target-lesion revascularization (TLR) and the primary safety endpoint was scaffold thrombosis. Despite performing routine high-pressure postdilation, postintervention IVUS detected BVS underexpansion/malapposition in 53 scaffolds (28.7%), requiring further postdilation. At a median follow-up of 60 months (interquartile range, 45-73 months), TLR and scaffold thrombosis occurred in 16 patients (10.3%) and 1 patient (0.6%), respectively. At univariable analysis, IVUS-guided scaffold implantation was associated with lower TLR (odds ratio, 0.24; 95% confidence interval, 0.09-0.62; P<.01). Conclusion. The use of first-generation BVS with OIT in real-world patients/lesions was associated with acceptable long-term outcomes.
AB - Background. Previous randomized controlled trials demonstrated a higher rate of stent thrombosis with bioresorbable vascular scaffold (BVS) implantation as compared with second-generation drug-eluting stent in selected patients/lesions. However, long-term outcomes of BVS implantations that utilize an optimized technique (OIT) in unselected patients/lesions are lacking. The aim of this study was to assess the real-world, long-term clinical outcomes of BVS (Absorb; Abbott Vascular) with OIT. Methods and Results. In a cohort of 156 patients, a total of 347 BVS devices (435 lesions) were implanted, with intravascular ultrasound (IVUS) guidance utilized in 303 (87.3%) of the scaffolds. The primary efficacy endpoint was target-lesion revascularization (TLR) and the primary safety endpoint was scaffold thrombosis. Despite performing routine high-pressure postdilation, postintervention IVUS detected BVS underexpansion/malapposition in 53 scaffolds (28.7%), requiring further postdilation. At a median follow-up of 60 months (interquartile range, 45-73 months), TLR and scaffold thrombosis occurred in 16 patients (10.3%) and 1 patient (0.6%), respectively. At univariable analysis, IVUS-guided scaffold implantation was associated with lower TLR (odds ratio, 0.24; 95% confidence interval, 0.09-0.62; P<.01). Conclusion. The use of first-generation BVS with OIT in real-world patients/lesions was associated with acceptable long-term outcomes.
KW - Bioresorbable scaffold
KW - Intravascular ultrasound
KW - Multivessel disease
KW - Stable angina
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M3 - Article
C2 - 33443487
AN - SCOPUS:85101896091
SN - 1042-3931
VL - 33
SP - E115-E122
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 2
ER -