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

Autor: Altisent OA; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain. Electronic address: oabduljawadaltisent@gmail.com., Goncalves-Ramírez LR; Department of cardiology, Hospital Clínico Universitario de Valladolid, CIBERCV, Valladolid, Spain; Department of cardiology, Hospital Universitario de León, León, Spain., Fernández L; Department of cardiology, Hospital Universitari Mutua de Terrassa, Terrassa, Spain., Viladés D; Department of Cardiovascular Surgery and Cardiology, Clínica Creu Blanca, Barcelona, Spain., Gutiérrez E; Department of cardiology, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain., Mitomo S; Department of cardiology, Hospital San Raffaele, Milano, Italy; Department of cardiology, Interventional Cardiology Unit, New Tokyo Hospital, Chiba, Japan., Latib A; Department of cardiology, Division of Cardiology, Montefiore Medical Center, New York, New York., Córdoba-Soriano JG; Department of cardiology, Complejo Hospitalario Universitario de Albacete, Albacete, Spain., Adeliño R; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., Amat-Santos I; Department of cardiology, Hospital Clínico Universitario de Valladolid, CIBERCV, Valladolid, Spain., Muñoz JF; Department of cardiology, Hospital Universitari Mutua de Terrassa, Terrassa, Spain., Elízaga J; Department of cardiology, Hospital Universitario Gregorio Marañón, CIBERCV, Madrid, Spain., Bezzera H; University of South Florida, Tampa, Florida., Pereira GTR; University Hospitals, Cleveland, Ohio., de Prado AP; Department of cardiology, Hospital Universitario de León, León, Spain., Carrillo X; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., Fernández-Nofrerias E; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., Vilalta V; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., Rodríguez-Leor O; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., Llibre C; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., Fadeuilhe E; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., Trujillo A; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., Mauri J; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., de la Torre Hernández JM; Department of cardiology, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain., Bayes-Genís A; Department of cardiology, Germans Trias I Pujol University Hospital, CIBERCV, Badalona, Spain., Puri R; Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio. Electronic address: purir@ccf.org.
Jazyk: angličtina
Zdroj: The American journal of cardiology [Am J Cardiol] 2022 Apr 01; Vol. 168, pp. 55-63. Date of Electronic Publication: 2022 Jan 17.
DOI: 10.1016/j.amjcard.2021.12.037
Abstrakt: 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.
Competing Interests: Disclosures Dr. Amat-Santos has received a nonconditional grant from Abbott. Dr. Latib is a consultant for Abbott, Boston Scientific, Medtronic, and Philips. The remaining authors have no conflicts of interest to declare.
(Copyright © 2022 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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