Effect of Post-Dilatation Following Primary PCI With Everolimus-Eluting Bioresorbable Scaffold Versus Everolimus-Eluting Metallic Stent Implantation
| Autor: | Gerrit Anne van Es, Patrick W. Serruys, Andrés Iñiguez, Lisette Okkels Jensen, Yoshinobu Onuma, Yohei Sotomi, Stephan Windecker, Sjoerd H. Hofma, Manel Sabaté, Angel Cequier, Maarten J. Suttorp, Salvatore Brugaletta, Evald Høj Christiansen, Kyohei Yamaji, Lorenz Räber |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Everolimus medicine.diagnostic_test business.industry medicine.medical_treatment Lumen (anatomy) Percutaneous coronary intervention Stent 030204 cardiovascular system & hematology medicine.disease 03 medical and health sciences 0302 clinical medicine Optical coherence tomography Internal medicine Conventional PCI medicine Cardiology 030212 general & internal medicine Myocardial infarction Cardiology and Cardiovascular Medicine business Bioresorbable scaffold medicine.drug |
| Zdroj: | JACC: Cardiovascular Interventions. 10:1867-1877 |
| ISSN: | 1936-8798 |
| Popis: | Objectives This study sought to investigate the effect of post-dilatation on angiographic and intracoronary imaging parameters in the setting of primary percutaneous coronary intervention comparing the everolimus-eluting bioresorbable scaffold (BRS) with the everolimus-eluting metallic stent (EES). Background Routine post-dilatation of BRS has been suggested to improve post-procedural angiographic and subsequent device-related clinical outcomes. Methods In the ABSORB STEMI TROFI II trial, 191 patients with ST-segment elevation myocardial infarction were randomly assigned to treatment with BRS (n = 95) or EES (n = 96). Minimal lumen area and healing score as assessed by optical coherence tomography at 6 months were compared between BRS- and EES-treated patients stratified according to post-dilatation status. Results Primary percutaneous coronary intervention with post-dilatation was performed in 48 (50.5%) BRS- and 25 (25.5%) EES-treated lesions. There were no differences in baseline characteristics and post-procedural minimal lumen diameter between groups. In the BRS group, lesions with post-dilatation were associated with a trend toward a smaller minimal lumen area at 6 months (5.07 ± 1.68 mm2 vs. 5.72 ± 1.77 mm2; p = 0.09) and significantly larger angiographic late lumen loss (0.28 ± 0.34 mm vs. 0.12 ± 0.25 mm; p = 0.02), whereas no difference was observed in the EES arm (5.46 ± 2.18 mm2 vs. 5.55 ± 1.77 mm2; p = 0.85). The neointimal healing score was low and comparable between groups with and without post-dilation (BRS: 1.55 ± 2.61 vs. 1.92 ± 2.17; p = 0.48; EES: 2.50 ± 3.33 vs. 2.90 ± 4.80; p = 0.72). Conclusions In the setting of selected patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention with BRS or EES, post-dilatation did not translate into larger lumen area or improved arterial healing at follow-up. (ABSORB STEMI: The TROFI II; NCT01986803) |
| Databáze: | OpenAIRE |
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