Iwańczyk Sylwia, Hiczkiewicz Jarosław, Araszkiewicz Aleksander, Łanocha Magdalena, Adamczak Daria, Faron Wojciech, Grajek Stefan, Lesiak Maciej
1st Department of Cardiology, University of Medical Sciences,Poznan, Poland, Dluga 1/2, 61-848 Poznan, Poland.
Cardiol J. 2018;25(4):479-486. doi: 10.5603/CJ.a2017.0131. Epub 2017 Nov 23.
Bioresorbable vascular scaffolds (BVS) have emerged as a new treatment option in cardiovascular medicine. Nonetheless, there is still limited data on the use of these novel devices in patients with acute coronary syndromes (ACS). The purpose of this study was to evaluate the feasibility and efficacy of BVS implantation in patients with ACS.
The present report is a prospective, two-center registry that involved 165 consecutive patients hospitalized with the diagnosis of ACS and treated with the Absorb BVS (Abbot Vascular, Santa Clara, USA). During 1-year, all patients were monitored for the following endpoints: death, myocardial infarction (MI), scaffold thrombosis (ST), target lesion revascularization (TLR), target vessel revascularization (TVR) and target vessel failure (TVF), defined as cardiac death, target vessel MI, and TVR.
A total of 165 patients underwent 179 BVS implantations. 94 patients were diagnosed with unstable angina (UA; 57.6%), 45 with non-ST-segment elevation myocardial infarction (NSTEMI; 27.3%) and 26 with ST-segment elevation myocardial infarction (STEMI; 15.7%). Procedural success was achieved in all patients with thrombolysis in myocardial infarction flow 3. During a follow-up of 14.1 ± 8.5 months (median 12.4 months, IQR 8.7 [8.4 to 12.1] months) death occurred in 4 (2.4%) patients, including 2 (1.3%) cardiac deaths. There was only 1 case of subacute ST (0.66%), without late ST. The incidence of MI, TLR, TVR and TVF were: 2.65%, 2.65%, 7.95%, 9.3%, respectively.
The present results suggest that BVS implantation in ACS patients is feasible and safe in highly experienced centers. One-year clinical results are encouraging with a low rate of stent thrombosis.
生物可吸收血管支架（BVS）已成为心血管医学领域一种新的治疗选择。尽管如此，关于这些新型装置在急性冠状动脉综合征（ACS）患者中的应用数据仍然有限。本研究的目的是评估BVS植入术在ACS患者中的可行性和疗效。
本报告是一项前瞻性、双中心注册研究，纳入了165例连续住院且诊断为ACS并接受Absorb BVS（美国圣克拉拉雅培血管公司）治疗的患者。在1年期间，对所有患者监测以下终点：死亡、心肌梗死（MI）、支架血栓形成（ST）、靶病变血运重建（TLR）、靶血管血运重建（TVR）以及靶血管失败（TVF），后者定义为心源性死亡、靶血管MI和TVR。
共有165例患者接受了179次BVS植入术。94例患者诊断为不稳定型心绞痛（UA；57.6%），45例为非ST段抬高型心肌梗死（NSTEMI；27.3%），26例为ST段抬高型心肌梗死（STEMI；15.7%）。所有患者心肌梗死溶栓血流3级时手术均成功。在14.1±8.5个月（中位数12.4个月，四分位间距8.7 [8.4至12.1]个月）的随访期间，4例（2.4%）患者死亡，其中2例（1.3%）为心源性死亡。仅1例亚急性ST（0.66%），无迟发性ST。MI、TLR、TVR和TVF的发生率分别为：2.65%、2.65%、7.95%、9.3%。
目前结果表明，在经验丰富的中心，ACS患者植入BVS是可行且安全的。1年临床结果令人鼓舞，支架血栓形成率较低。
