Bioresorbable Vascular Scaffold With Optimized Implantation Technique: Long-Term Outcomes From a Single-Center Experience

Stefano Albani, Francesco Giannini, Satoru Mitomo, Enrico Fabris, Antonio Mangieri, Francesco Ponticelli, Arif A. Khokhar, Marco Toselli, Azeem Latib, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)E115-E122
JournalThe Journal of invasive cardiology
Volume33
Issue number2
StatePublished - Feb 1 2021

Keywords

  • bioresorbable scaffold
  • intravascular ultrasound
  • multivessel disease
  • stable angina

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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