Procedural Feasibility and Clinical Outcomes in Propensity-Matched Patients Treated With Bioresorbable Scaffolds vs New-Generation Drug-Eluting Stents

Background: There is limited experience regarding the feasibility of the bioresorbable vascular scaffold (BVS) in "all-comer" populations. We evaluated the impact of BVS use on procedural factors and clinical outcomes compared with the new-generation drug-eluting stent (DES). Methods: We analyzed procedural feasibility and outcome data from 292 consecutive patients treated with either a new-generation DES or a BVS between May 2008 and May 2014 using propensity-score (PS) matching. Results: After PS matching, 96 patients treated with BVSs and 96 patients treated with DESs were selected. Lesion characteristics were similar between the 2 groups. Maximum balloon size after dilation was larger and maximum inflation pressure was higher in the BVS group, despite similar quantitative coronary angiography results. Procedure time (114.7 ± 39.2 minutes vs 90.4 ± 38.2 minutes; P < 0.001), amount of contrast medium used (268.3 ± 104.2 mL vs 229.2 ± 122.2 mL; P= 0.02), and fluoroscopy time (42.4 ± 17.9 minutes vs 34.5 ± 19.7 minutes; P < 0.001) were significantly increased in the BVS group compared with the DES group. In multivariable analysis, BVS use was identified as an independent predictor of long (> 120 minutes) procedure time (odds ratio, 7.83; 95% confidence interval, 2.81-25.78; P < 0.001). Procedural success (93.6% BVS vs 95.7% DES; P= 0.51) and 1-year major adverse cardiovascular events (10.2% BVS vs 10.5% DES; P= 0.82) were similar between the groups. Conclusions: In real-world patients with predominantly complex lesions treated with BVSs, procedural success rates and short-term outcomes similar to those seen in patients treated with DESs are observed at the expense of longer procedure and fluoroscopy times.