ImpaCt of an optimal Implantation strategy on Absorb long-term Outcomes: the CIAO Registry
| Autor: | Damiano Regazzoli, Ferdinando Varbella, Giuseppe Caramanno, Alberto Ranieri De Caterina, Flavio Ribichini, Alessandro Durante, Bruno Loi, Elisa Nicolini, Attilio Varricchio, Leonardo Spedicato, A Rossi, Raffaela Fetiveau, Alfonso Ielasi, Maria Carmen De Angelis, Bernardo Cortese, Andrea Cuculo, Sergio Berti, Arnaldo Poli, Mario Iannaccone, Maurizio Tespili, Antonio Colombo, Gianfranco De Candia, Massimo Leoncini, Antonio Centola, Claudio Rapetto, Tommaso Piva, Raimondo Pirisi, Marco De Carlo, Giorgio Quadri, Luca Testa, Gaetano Di Palma, Anna Sonia Petronio, Enrico Favaretto, Mario Bollati, Enrico Cerrato, Roberto Garbo, Salvatore Geraci |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Bioresorbable scaffold
medicine.medical_specialty Time Factors medicine.medical_treatment Population 030204 cardiovascular system & hematology Prosthesis Design Balloon Coronary artery disease Percutaneous coronary intervention 03 medical and health sciences 0302 clinical medicine Interquartile range Absorbable Implants medicine Humans Registries 030212 general & internal medicine Myocardial infarction education education.field_of_study business.industry General Medicine medicine.disease Thrombosis Surgery Treatment Outcome Cardiology and Cardiovascular Medicine business |
| Popis: | Aim To compare the long-term outcomes of patients implanted with Absorb bioresorbable scaffold (BRS) with optimal versus suboptimal technique. Methods and results All patients who received an Absorb between March 2012 and January 2016 were selected from 19 Italian centers databases to assess the impact of an optimal implantation technique (CIAO criteria) on long-term device-oriented composite end-point (DOCE) - including cardiac death (CD), target-vessel myocardial infarction (TV-MI) and ischemia-driven target lesion revascularization (ID-TLR) - on its single components and on scaffold thrombosis (ScT). CIAO criteria consist of predilation (balloon/vessel ratio 1:1), correct sizing (BRS/proximal reference vessel diameter -RVD- ratio 0.8–1.2) and high-pressure postdilation with non-compliant (NC) balloon (≥20 atm for balloon/BRS ratio 1:1 or ≥16 atm for a 0.25–0.5 mm oversized balloon). Among the 1.434 patients analyzed, 464 (32.4%) fulfilled all CIAO criteria for every BRS implanted (CIAO 3 group), while 970 (67.6%) did not in at least one of the received BRS (CIAO 0-1-2 group). At 31.0 (interquartile range -IQR- 24.8–38.5) months follow-up, CIAO criteria did not impact on DOCE (8.2% vs. 8.0%, p = 0.92), ID-TLR (6.9% vs. 7.1%, p = 0.72) or ScT (1.9% vs. 1.8%, p = 0.80) in the overall population. At multivariate analysis overall BRS length ( p = 0.001), severely calcified lesions (p = 0.03) and absence of CIAO criteria (CIAO 0, p = 0.005) were independent predictors of DOCE in long-term follow-up. Conclusion Our data suggest that strict application of an optimal Absorb implantation technique doesn't improve long-term DOCE or ScT but may mitigate the worse outcome of patients with calcific lesions. |
| Databáze: | OpenAIRE |
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