Long-Term Intracoronary Structural and Vasomotor Assessment of the ABSORB Bioresorbable Vascular Scaffold

Omar Abdul Jawad Altisent, Luis Renier Goncalves-Ramírez, Leticia Fernández, David Viladés, Enrique Gutiérrez, Satoru Mitomo, Azeem Latib, Juan Gabriel Córdoba-Soriano, Raquel Adeliño, Ignacio Amat-Santos, Juan Francisco Muñoz, Jaime Elízaga, Hiram Bezzera, Gabriel Tensol Rodrigues Pereira, Armando Pérez de Prado, Xavier Carrillo, Eduard Fernández-Nofrerias, Victoria Vilalta, Oriol Rodríguez-Leor, Cinta LlibreEdgar Fadeuilhe, Aaron Trujillo, Josepa Mauri, Jose M. de la Torre Hernández, Antoni Bayes-Genís, Rishi Puri

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

We systematically categorized the longer-term (≥3 years) structural and functional characteristics of the ABSORB bioresorbable vascular scaffold (BVS) using optical coherence tomography imaging and coronary vasomotor reactivity testing and further compared the functional characteristics of BVS stented versus remote coronary segments. A total of 92 patients (mean age 56.4 ± 9.7 years, 22.8% women) who underwent percutaneous coronary intervention (76% with acute coronary syndrome) using the ABSORB BVS (112 lesions) were included. Optical coherence tomography analysis (38,790 visible struts) comprised in-segment quantitative lumen/plaque and semiquantitative plaque composition analysis of the neointimal pattern. Epicardial endothelium-dependent and-independent vasomotion was defined as any vasodilatation at low/intermediate intracoronary dose of acetylcholine (ACh) and nitroglycerine, assessed using quantitative coronary angiography. At a median time of 3.2 years follow-up, 79.8% of BVS segments still demonstrated visible struts with a predominant neointimal fibrotic healing pattern in 84% of BVS segments, with 99.5% of struts demonstrating coverage with apposition. Compared with remote segments, BVS segments demonstrated less endothelium-dependent vasodilatation at low (p = 0.06) and intermediate ACh doses (p = 0.04). Hypertension, longer time interval from index percutaneous coronary intervention, and the degree of in-BVS segment neointimal volume (p <0.03 for all) were each independently associated with abnormal BVS endothelium-dependent vasomotor function. Endothelium-independent function was more likely preserved in non-BVS (remote) segments compared with BVS segments (p = 0.06). In conclusion, at 3+ years post-ABSORB BVS insertion, the rate of complete scaffold resorption was low and residual strut presence was high, with a dominant fibrous healing response contributing toward neointimal hyperplasia and endothelium-dependent and-independent vasomotor dysfunction.

Original languageEnglish (US)
Pages (from-to)55-63
Number of pages9
JournalAmerican Journal of Cardiology
Volume168
DOIs
StatePublished - Apr 1 2022

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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