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Catheter Cardiovasc Interv. 2015 Oct;86(4):E180-9. doi: 10.1002/ccd.26006. Epub 2015 May 25.

A 12-month angiographic and optical coherence tomography follow-up after bioresorbable vascular scaffold implantation in patients with ST-segment elevation myocardial infarction.

Author information

1
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
2
Krakow Cardiovascular Research Institute, Krakow, Poland.
3
Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland.
4
Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.
5
Department of Cardiology, Thorax Institute, Hospital Clinic, University of Barcelona, Barcelona, Spain.

Abstract

OBJECTIVES:

The aim of the study was to evaluate the healing process at 12 months after ABSORB™ bioresorbable vascular scaffold (BVS) implantation in patients with ST-segment elevation myocardial infarction (STEMI).

BACKGROUND:

There is currently no data on long-term BVS performance in the acute thrombotic setting. The underlying altered plaque pathomorphology may impact the neointima healing pattern, potentially making it different to that observed in stable coronary artery disease (CAD).

METHODS:

We have performed an angiographic and optical coherence tomography (OCT) 12-month follow-up of 19 STEMI patients who were treated with a BVS implantation (23 scaffolds). An independent core laboratory performed a paired analysis of the corresponding frames at baseline and follow-up.

RESULTS:

At 12 months, the OCT follow-up showed a decrease in the mean lumen area (8.29 ± 1.53 mm(2) vs. 6.82 ± 1.57 mm(2) , P < 0.001), but no significant change in the mean scaffold area (8.49 ± 1.53 mm(2) vs. 8.90 ± 1.51 mm(2) ). Significant decreases in malapposed strut ratio (4.9 ± 8.65% vs. 0.4 ± 1.55%, P < 0.001) and malapposition area (0.29 ± 0.60 mm(2) 0.08 ± 0.32 mm(2) , P = 0.002) were observed. A nonhomogenous proliferation of neointima was revealed with a symmetry index of 0.15 (0.08-0.27), a mean neointima thickness of 203 μm (183-249) and mean neointima area of 2.07 ± 0.51 mm(2) . The quantitative coronary angiography showed late lumen loss of 0.08 ± 0.23 mm and no significant change in the minimal lumen diameter (P = 0.11). There were no major adverse cardiovascular events (MACE), except for one nontarget vessel revascularization.

CONCLUSIONS:

The OCT revealed a favorable healing pattern after BVS implantation in a STEMI population.

KEYWORDS:

ST-segment elevation myocardial infarction; bioresorbable vascular scaffold; long-term follow-up; neointima healing process; optical coherence tomography

PMID:
26015294
DOI:
10.1002/ccd.26006
[Indexed for MEDLINE]

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