Feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios
| Autor: | Verena Geyer, Paul Erne, Jelena-Rima Ghadri, Thomas F. Lüscher, Christian Hagl, Catharina A. Neumann, Milosz Jaguszewski, Johanna Diekmann, Manuel Zipponi, Mia Aurelia Huber, Dana Roxana Bataiosu, Christian Templin |
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| Přispěvatelé: | University of Zurich, Templin, Christian |
| Jazyk: | angličtina |
| Předmět: |
Adult
Male medicine.medical_specialty Treatment outcome 610 Medicine & health Coronary Artery Disease Prosthesis Design 2705 Cardiology and Cardiovascular Medicine Coronary artery disease Broad spectrum Tissue scaffolds Blood vessel prosthesis Absorbable Implants Medicine Prosthesis design Humans Everolimus Bioresorbable vascular scaffold Aged Retrospective Studies Sirolimus Original Paper Tissue Scaffolds Optical coherence tomography business.industry Drug-Eluting Stents General Medicine Simple type Middle Aged medicine.disease Surgery Blood Vessel Prosthesis Equipment Failure Analysis Treatment Outcome 10209 Clinic for Cardiology Feasibility Studies Female business Cardiology and Cardiovascular Medicine Immunosuppressive Agents Switzerland |
| Zdroj: | Clinical Research in Cardiology |
| ISSN: | 1861-0684 |
| DOI: | 10.1007/s00392-014-0757-4 |
| Popis: | Background Bioresorbable vascular scaffolds (BVS) have become an emerging tool to treat coronary artery disease. However, the current use of BVS is still widely restricted to stable patients and non-complex lesions. In real-world practice patients are far more complex than those with simple type A lesions and the extended use of BVS to complex lesions and high-risk patients needs to be evaluated. Therefore, we sought to investigate the feasibility and performance of BVS in a broad spectrum of patients. Methods 106 patients underwent in total 193 BVS implantations. We assessed the device-related (cardiac death, target vessel myocardial infarction, ischemia-driven target lesion revascularization) and patient-related (all-cause death, any reinfarction and any revascularization) composite outcomes. Results 90 % of patients (n = 95) had at least one of the following characteristics: >65 years (35 %), ACS (42 %), tortuous vessels (13 %), calcified (17 %) or thrombotic lesions (12 %), lesions defined as AHA type B2/C (42 %), bifurcations (16 %), chronic total occlusions (9 %) or restenosis (14 %). There was no evidence of significant edge dissection, huge thrombus load or incidence of scaffold dislodgement or scaffold disruption in optical coherence tomography pullbacks. Out of 10,157 struts evaluated within 1,117 cross-sections, 302 were classified as malapposed (2.9 %). During a mean follow-up of 147 ± 119 days the rate of device-related events was 2.0 %, whereas patient-related composite events occurred in 6.1 %. Conclusions Our results strongly suggest that BVS implantation is feasible in a wide spectrum of patients and complex anatomy of coronary lesions. Long-term outcome of BVS should be further investigated in unrestricted settings in randomized controlled trials. Electronic supplementary material The online version of this article (doi:10.1007/s00392-014-0757-4) contains supplementary material, which is available to authorized users. |
| Databáze: | OpenAIRE |
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