Procedural outcomes of patients with calcified lesions treated with bioresorbable vascular scaffolds

Aims: To compare the feasibility, procedural and clinical outcomes after implantation of bioresorbable vascular scaffolds (BVS) in patients with calcified lesions. Methods and results: We assessed the feasibility of BVS implantation and procedural outcomes in patients with and without calcific lesions. The primary outcome was angiographic and procedural success. Secondary outcomes included major adverse cardiovascular events (MACE). Of 163 patients, 62 (38%) had calcified lesions. Patients with calcific lesions had a higher prevalence of diabetes (35.5% vs. 22.8%, p=0.078) and chronic kidney disease (31.1% vs. 13.9%, p=0.008), and higher SYNTAX scores (18.9 ±9.7 vs. 15.1 ±9.0, p=0.017). Calcific lesions required longer procedures (126.4 ±39.8 vs. 106.9 ±37.1 min, p=0.015), more frequent use of dedicated devices and IVUS. Acute gain (1.83 ±0.6 vs. 1.86 ±0.6, p=0.732) and angiographic success were similar (98% non-calcific vs. 95.2% calcific, p=0.369), whereas procedural success was reduced in patients with calcific lesions (94.1% vs. 83.9%, p=0.034) due to higher rates of periprocedural myocardial infarction (MI) (5% vs. 13.1%, p=0.067). During the median follow-up time of 14 months MACE rates (10.9% non-calcific vs. 12.9% calcific, plog-rank=0.546) were similar. Conclusions: Treating calcific lesions with BVS is feasible with high angiographic success rates, at the expense of longer procedure times, aggressive lesion preparation and increased rates of periprocedural MI.