Paradies Valeria, Smits Pieter C, Vachojannis Georgios J, Royaards Kees-Jan, Wassing Jochem, van der Ent Martin
Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
Department of Cardiology, Maasstad Hospital, Rotterdam, Netherlands.
Cardiovasc Revasc Med. 2018 Apr;19(3 Pt A):279-285. doi: 10.1016/j.carrev.2017.09.001. Epub 2017 Sep 10.
Little is known about the long term development of the tissue bridges covering the struts of bioresorbable vascular scaffold (BVS) at the side branches (SB) ostium. This study aims at assessing the resorption process of jailed SB after BVS implantation.
We performed both Optical Coherence Tomography (OCT) and Intravascular Ultrasound (IVUS) analysis of 7 patients enrolled in the ABSORB Cohort B trial at our center. Orifice SB area and mean thickness of tissue bridge covering SB were calculated from 2D assessment. The number of SB orifice compartments separated by BRS struts was analysed by using 3D OCT reconstruction.
At 5years follow-up, no struts could be identified. Between 3 and 5years, both lesion-level and cross section-level OCT findings showed a significant increase in Mean lumen area (MLA) (4.67±1.66mm vs. 5.57±1.57mm; p=0.04) as well as Minimum Lumen Area (MinLA) (5.98±1.98mm vs. 6.73±1.87mm; p=0.04). Moreover, eccentricity index showed a significant reduction between 3 and 5years (0.28±0.35mm vs. 0.16±0.06mm; p=0.04). We identified a total of 3 SBs ostia in the segments treated with BVS. Between 3 and 5years follow-up in all SB analysed, we detected a decrease of mean tissue bridge thickness and an increase of calculated SBs area.
In our serial OCT, a significant decrease of tissue bridge formation together with SB orifice area enlargement from 3 to 5year follow-up has been proved.
关于生物可吸收血管支架（BVS）侧支（SB）开口处覆盖支架的组织桥的长期发展情况，人们了解甚少。本研究旨在评估BVS植入后被封堵的SB的吸收过程。
我们对在我们中心参加ABSORB队列B试验的7名患者进行了光学相干断层扫描（OCT）和血管内超声（IVUS）分析。通过二维评估计算开口处SB面积和覆盖SB的组织桥的平均厚度。使用三维OCT重建分析由BRS支架分隔的SB开口隔室的数量。
在5年随访时，未发现支架。在3至5年之间，病变水平和横截面水平的OCT结果均显示平均管腔面积（MLA）显著增加（4.67±1.66mm对5.57±1.57mm；p = 0.04）以及最小管腔面积（MinLA）显著增加（5.98±1.98mm对6.73±1.87mm；p = 0.04）。此外，偏心率指数在3至5年之间显著降低（0.28±0.35mm对0.16±0.06mm；p = 0.04）。我们在接受BVS治疗的节段中总共识别出3个SB开口。在所有分析的SB的3至5年随访期间，我们检测到平均组织桥厚度减小，计算出的SB面积增加。
在我们的系列OCT中，已证实在3至5年随访中组织桥形成显著减少，同时SB开口面积增大。
