TY - JOUR
T1 - Mid-term clinical outcomes of ABSORB bioresorbable vascular scaffold versus everolimus-eluting stent for coronary bifurcation lesions
AU - Naganuma, Toru
AU - Kawamoto, Hiroyoshi
AU - Panoulas, Vasileios F.
AU - Latib, Azeem
AU - Tanaka, Akihito
AU - Mitomo, Satoru
AU - Ruparelia, Neil
AU - Jabbour, Richard J.
AU - Chieffo, Alaide
AU - Carlino, Mauro
AU - Montorfano, Matteo
AU - Colombo, Antonio
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
Copyright:
Copyright 2018 Elsevier B.V., All rights reserved.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background Data regarding bioresorbable vascular scaffolds (BVS) use in coronary bifurcation lesions are limited. The aim of this study was to compare mid-term clinical outcomes of all-comer patients treated with BVS versus everolimus-eluting stents (EES) for bifurcation lesions. Methods A total of 351 non-left-main bifurcation lesions in 323 all-comer patients were treated either with BVS (166 bifurcations in 147 patients) or EES (185 bifurcations in 176 patients). The study endpoint was propensity-score adjusted target lesion failure (TLF) defined as the composite of cardiac death, target vessel myocardial infarction and clinically driven target lesion revascularization. Results Intravascular ultrasound and/or optical coherence tomography were more frequently utilized in the BVS group as compared to the EES one (89.8% versus 13.5%, p < 0.001). In the BVS group, both predilation (97.6%) and postdilation (100%) of the main branch were performed in almost all-cases. Provisional single-stenting strategy was more frequently used in the BVS group (79.5% versus 68.1%, p = 0.016). At the median follow-up of 698 days, there was no significant difference in the propensity score adjusted analysis for TLF (HR: 1.19, 95% CI: 0.47 to 3.03, p = 0.718). A similar result was obtained when performing propensity-score matched analysis. Conclusions BVS use for coronary bifurcation lesions in real world patients was associated with comparable TLF rates up to 2-year follow-up as compared to EES. The high incidence of intravascular imaging guidance, meticulous lesion preparation, and aggressive postdilation of BVS treated lesions may have played a role in achieving equivalence to EES.
AB - Background Data regarding bioresorbable vascular scaffolds (BVS) use in coronary bifurcation lesions are limited. The aim of this study was to compare mid-term clinical outcomes of all-comer patients treated with BVS versus everolimus-eluting stents (EES) for bifurcation lesions. Methods A total of 351 non-left-main bifurcation lesions in 323 all-comer patients were treated either with BVS (166 bifurcations in 147 patients) or EES (185 bifurcations in 176 patients). The study endpoint was propensity-score adjusted target lesion failure (TLF) defined as the composite of cardiac death, target vessel myocardial infarction and clinically driven target lesion revascularization. Results Intravascular ultrasound and/or optical coherence tomography were more frequently utilized in the BVS group as compared to the EES one (89.8% versus 13.5%, p < 0.001). In the BVS group, both predilation (97.6%) and postdilation (100%) of the main branch were performed in almost all-cases. Provisional single-stenting strategy was more frequently used in the BVS group (79.5% versus 68.1%, p = 0.016). At the median follow-up of 698 days, there was no significant difference in the propensity score adjusted analysis for TLF (HR: 1.19, 95% CI: 0.47 to 3.03, p = 0.718). A similar result was obtained when performing propensity-score matched analysis. Conclusions BVS use for coronary bifurcation lesions in real world patients was associated with comparable TLF rates up to 2-year follow-up as compared to EES. The high incidence of intravascular imaging guidance, meticulous lesion preparation, and aggressive postdilation of BVS treated lesions may have played a role in achieving equivalence to EES.
KW - Bioresorbable vascular scaffold
KW - Coronary bifurcation
KW - Intravascular imaging guidance
KW - Lesion preparation
KW - Postdilation
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U2 - 10.1016/j.ijcard.2017.03.123
DO - 10.1016/j.ijcard.2017.03.123
M3 - Article
C2 - 28867010
AN - SCOPUS:85028532986
VL - 246
SP - 26
EP - 31
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
ER -