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JACC Cardiovasc Interv. 2014 Jul;7(7):741-50. doi: 10.1016/j.jcin.2014.01.165.

ABSORB biodegradable stents versus second-generation metal stents: a comparison study of 100 complex lesions treated under OCT guidance.

Author information

1
NIHR Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom; Department of Heart and Vessels, AOUC Careggi, Florence, Italy.
2
NIHR Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom; Department of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara, Italy.
3
NIHR Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom.
4
Department of Clinical and Experimental Medicine, University of Eastern Piedmont, Novara, Italy.
5
National Heart Centre Singapore, Singapore.
6
Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
7
Department of Heart and Vessels, AOUC Careggi, Florence, Italy.
8
NIHR Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom. Electronic address: c.dimario@rbht.nhs.uk.

Abstract

OBJECTIVES:

The aim of this study was to compare the acute performance of the PLLA ABSORB bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) with second-generation metal drug-eluting stents (DES) in complex coronary artery lesions.

BACKGROUND:

Thick polymer-based BVS have different mechanical properties than thin second-generation DES. Data on the acute performance of BVS are limited to simple coronary lesions treated in trials with strict inclusion criteria.

METHODS:

Fifty complex coronary lesions (all type American College of Cardiology/American Heart Association B2-C) treated with a BVS undergoing a final optical coherence tomography (OCT) examination were compared with an equal number of matched lesions treated with second-generation DES. The following stent performance indexes were assessed with OCT: mean and minimal area, residual area stenosis (RAS), incomplete strut apposition (ISA), tissue prolapse, eccentricity index, symmetry index, strut fracture, and edge dissection.

RESULTS:

One hundred lesions from 73 patients were analyzed. A higher balloon diameter/reference vessel diameter ratio was used for predilation in the BVS group (p < 0.01). Most of the BVS and DES were post-dilated with short noncompliant (NC) balloons of similar diameter. OCT showed in the BVS group a higher tissue prolapse area (p = 0.08) and greater incidence of ISA at the proximal edge (p = 0.04) with no difference in the overall ISA. The RAS was 20.2% in the BVS group and 21.7% in the DES group (p = 0.32). There was no difference in the eccentricity index. The minimal and mean lumen areas were similar in the 2 groups. Two cases of strut fractures occurred after the BVS, whereas none was observed in the DES.

CONCLUSIONS:

Based on OCT, the BVS showed similar post-procedure area stenosis, minimal lumen area, and eccentricity index as second-generation DES. The different approach for lesion preparation and routine use of OCT guidance during BVS expansion may have contributed to these results.

KEYWORDS:

bioresorbable vascular scaffold; drug-eluting stent; optical coherence tomography; stent

PMID:
25060016
DOI:
10.1016/j.jcin.2014.01.165
[Indexed for MEDLINE]
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