Mid-term clinical outcomes of ABSORB bioresorbable vascular scaffold versus everolimus-eluting stent for coronary bifurcation lesions

Toru Naganuma, Hiroyoshi Kawamoto, Vasileios F. Panoulas, Azeem Latib, Akihito Tanaka, Satoru Mitomo, Neil Ruparelia, Richard J. Jabbour, Alaide Chieffo, Mauro Carlino, Matteo Montorfano, Antonio Colombo

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)26-31
Number of pages6
JournalInternational Journal of Cardiology
Volume246
DOIs
StatePublished - Nov 1 2017
Externally publishedYes

Keywords

  • Bioresorbable vascular scaffold
  • Coronary bifurcation
  • Intravascular imaging guidance
  • Lesion preparation
  • Postdilation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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