TY - JOUR
T1 - Early and midterm outcomes of bioresorbable vascular scaffolds for ostial coronary lesions
T2 - Insights from the GHOST-EU registry
AU - Gori, Tommaso
AU - Wiebe, Jens
AU - Capodanno, Davide
AU - Latib, Azeem
AU - Lesiak, Maciej
AU - Pyxaras, Stylianos A.
AU - Mehilli, Julinda
AU - Caramanno, Giuseppe
AU - Mario, Carlo Di
AU - Brugaletta, Salvatore
AU - Weber, Julia
AU - Capranzano, Piera
AU - Sabate, Manel
AU - Mattesini, Alessio
AU - Geraci, Salvatore
AU - Naber, Christoph K.
AU - Araszkiewicz, Aleksander
AU - Colombo, Antonio
AU - Tamburino, Corrado
AU - Nef, Holger
AU - Münzel, Thomas
N1 - Publisher Copyright:
©Europa Digital & Publishing 2016. All rights reserved.
PY - 2016/8
Y1 - 2016/8
N2 - Aims: We aimed to investigate the outcomes of bioresorbable vascular scaffolds (BVS) in coronary ostial lesions. Ostial lesions represent a challenging angiographic subset, with higher event rates compared with non-ostial lesions. BVS might be associated with advantages over the long term, but their safety in this setting remains to be explored. Methods and results: Procedural and 12-month follow-up data from consecutive patients treated with BVS for lesions located at the ostium of the right (RCA), left anterior (LAD) or circumflex (LCX) coronary in 11 European centres were collected. The primary device-oriented endpoint was defined as a combination of cardiovascular death, target vessel myocardial infarction or target lesion revascularisation. The database included a total of 1,549 lesions in 1,304 patients with a mean age of 62±11years. There were 90 ostial lesions (5.8%) in 84 patients (6.4%) located at the ostial RCA (14; 16%), LCX (29; 32%), or LAD (47; 52%). Patients presenting with ostial lesions did not differ from the remaining cohort except for a higher incidence of prior revascularisation. Predilation was performed in 97% of the lesions (vs. 96% in non-ostial, p=0.618), post-dilation in 43% (versus 58% in the non-ostial group, p=0.008). At quantitative coronary angiography, treatment of ostial lesions was associated with higher residual stenosis (30% [23-41] vs. 26% [20-37], p=0.035), but no difference in minimum lumen diameter existed (p=0.447). Follow-up data were available at 385 [362-465] days. The 12-month Kaplan-Meier estimated rates of scaffold thrombosis were 4.9% and 2.0% (ostial and non-ostial lesion groups, respectively, log-rank p=0.005). The device-oriented composite endpoint occurred, respectively, in 12.6% and 4.6% at 12 months (log-rank p=0.001). Treatment of ostial lesions was an independent predictor of this endpoint (p=0.0025, HR 2.65 [1.41-4.97]). Conclusions: In combination with a suboptimal implantation technique, treatment of coronary ostial lesions was an independent predictor of clinical events in a cohort of patients treated with BVS.
AB - Aims: We aimed to investigate the outcomes of bioresorbable vascular scaffolds (BVS) in coronary ostial lesions. Ostial lesions represent a challenging angiographic subset, with higher event rates compared with non-ostial lesions. BVS might be associated with advantages over the long term, but their safety in this setting remains to be explored. Methods and results: Procedural and 12-month follow-up data from consecutive patients treated with BVS for lesions located at the ostium of the right (RCA), left anterior (LAD) or circumflex (LCX) coronary in 11 European centres were collected. The primary device-oriented endpoint was defined as a combination of cardiovascular death, target vessel myocardial infarction or target lesion revascularisation. The database included a total of 1,549 lesions in 1,304 patients with a mean age of 62±11years. There were 90 ostial lesions (5.8%) in 84 patients (6.4%) located at the ostial RCA (14; 16%), LCX (29; 32%), or LAD (47; 52%). Patients presenting with ostial lesions did not differ from the remaining cohort except for a higher incidence of prior revascularisation. Predilation was performed in 97% of the lesions (vs. 96% in non-ostial, p=0.618), post-dilation in 43% (versus 58% in the non-ostial group, p=0.008). At quantitative coronary angiography, treatment of ostial lesions was associated with higher residual stenosis (30% [23-41] vs. 26% [20-37], p=0.035), but no difference in minimum lumen diameter existed (p=0.447). Follow-up data were available at 385 [362-465] days. The 12-month Kaplan-Meier estimated rates of scaffold thrombosis were 4.9% and 2.0% (ostial and non-ostial lesion groups, respectively, log-rank p=0.005). The device-oriented composite endpoint occurred, respectively, in 12.6% and 4.6% at 12 months (log-rank p=0.001). Treatment of ostial lesions was an independent predictor of this endpoint (p=0.0025, HR 2.65 [1.41-4.97]). Conclusions: In combination with a suboptimal implantation technique, treatment of coronary ostial lesions was an independent predictor of clinical events in a cohort of patients treated with BVS.
KW - Bioresorbable vascular scaffold ;coronary artery disease;ostial lesions
UR - http://www.scopus.com/inward/record.url?scp=84983787942&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84983787942&partnerID=8YFLogxK
U2 - 10.4244/EIJY15M09_10
DO - 10.4244/EIJY15M09_10
M3 - Article
C2 - 26348681
AN - SCOPUS:84983787942
SN - 1774-024X
VL - 12
SP - e550-e556
JO - EuroIntervention
JF - EuroIntervention
IS - 5
ER -