Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.
JACC Cardiovasc Interv. 2010 Nov;3(11):1190-8. doi: 10.1016/j.jcin.2010.07.016.
The aim of this study was to assess the differences in terms of curvature and angulation of the treated vessel after the deployment of either a metallic stent or a polymeric scaffold device.
Conformability of metallic platform stents (MPS) is the major determinant of geometric changes in coronary arteries caused by the stent deployment. It is not known how bioresorbable polymeric devices perform in this setting.
This retrospective study compares 102 patients who received an MPS (Multi-link Vision or Xience V, Abbott Vascular, Santa Clara, California) in the SPIRIT FIRST and II trials with 89 patients treated with the Revision 1.1 everolimus-eluting bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) from cohort B of the ABSORB (A bioabsorbable everolimus-eluting coronary stent system) trial. All patients were treated with a single 3 × 18 mm device. Curvature and angulation were measured with dedicated software by angiography.
Both the MPS and BVS groups had significant changes in relative region curvature (MPS vs. BVS: 28.7% vs. 7.5%) and angulation (MPS vs. BVS: 25.4% vs. 13.4%) after deployment. The unadjusted comparisons between the 2 groups showed for BVS a nonsignificant trend for less change in region curvature after deployment (MPS vs. BVS: 0.085 cm(-1) vs. 0.056 cm(-1), p = 0.06) and a significantly lower modification of angulation (MPS vs. BVS 6.4° vs. 4.3°, p = 0.03). By multivariate regression analysis, the independent predictors of changes in curvature and angulation were the pre-treatment region curvature, the pre-treatment region angulation, and the used device.
Bioresorbable vascular scaffolds have better conformability than conventional MPS. The clinical significance of the observed differences will require further investigation.
本研究旨在评估在部署金属支架或聚合物支架装置后，治疗血管的曲率和角度的差异。
金属平台支架（MPS）的顺应性是由支架部署引起的冠状动脉几何变化的主要决定因素。目前尚不清楚生物可吸收聚合物装置在这种情况下的表现如何。
本回顾性研究比较了 SPIRIT FIRST 和 II 试验中 102 例接受多链接 Vision 或 Xience V（雅培血管，圣克拉拉，加利福尼亚州）金属支架治疗的患者与 ABSORB（一种可生物吸收的依维莫司洗脱冠状动脉支架系统）试验 B 队列中 89 例接受 Revision 1.1 依维莫司洗脱生物可吸收血管支架（BVS）治疗的患者。所有患者均接受了单个 3×18mm 的装置治疗。通过专用软件测量曲率和角度。
支架和 BVS 组在部署后相对区域曲率（支架组与 BVS 组：28.7%比 7.5%）和角度（支架组与 BVS 组：25.4%比 13.4%）均有显著变化。两组之间的未调整比较显示，BVS 组在部署后区域曲率的变化趋势不显著（支架组与 BVS 组：0.085cm(-1)比 0.056cm(-1)，p=0.06），角度的变化显著降低（支架组与 BVS 组：6.4°比 4.3°，p=0.03）。通过多元回归分析，曲率和角度变化的独立预测因素是治疗前区域曲率、治疗前区域角度和使用的装置。
生物可吸收血管支架比传统的 MPS 具有更好的顺应性。观察到的差异的临床意义需要进一步研究。
