Maes Frédéric, Costerousse Olivier, Cieza Tomas, Henry Mélaine, Déry Jean-Pierre, Barbeau Gérald, Delarochellière Robert, Paradis Jean-Michel, Larose Eric, Nguyen Can M, Pirlet Charles, Mongrain Rosaire, Bertrand Olivier F
Institut Universitaire de Cardiologie et de Pneumologie de Québec, Québec, Canada.
Department of Mechanical Engineering, McGill University, Montréal, Canada.
Cardiovasc Revasc Med. 2018 Sep;19(6):700-704. doi: 10.1016/j.carrev.2018.01.002. Epub 2018 Jan 6.
Whether polymeric bioresorbable vascular scaffolds (BVS) implantation with transradial approach is feasible and safe is unknown. We compared the feasibility and safety of the transradial approach for BVS delivery with metallic drug-eluting stents (DES).
We identified 118 consecutive patients who underwent BVS implantation and we compared 30-days and 1-year results with 118 matched patients with DES. Patients were matched for age, sex, risk factors and clinical indication.
Rates of transradial approach were 98% in the BVS group vs 95% in the DES group (P = 0.16) with 5Fr used in 38% and 32% (P = 0.34), respectively. The number of stents was similar in both groups, 2.6 ± 1.5 vs 2.4 ± 1.3 (P = 0.23). Although maximal pressure for stent deployment was identical in both groups (16 ± 3 atm), more lesions were pre-dilated (83% vs 52%, P < 0.001) and post-dilated (71% vs 33%, P < 0.001) in the BVS group. Contrast volume (217 ± 97 vs 175 ± 108 ml, P < 0.001), fluoroscopy time (16 [10-23] vs 13 [8-21] min, P = 0.04) and procedure duration (65 ± 31 vs 56 ± 47 min, P = 0.045) were significantly higher in the BVS group. Major adverse cardiac events, including death, myocardial infarction and target vessel revascularization remained similar in both groups, 1.7% vs 0.8% (P = 0.56) at 30 days and 10% vs 8.5% (P = 0.66) at 1 year. At 1 year, stent thrombosis occurred in 2 (1.7%) patients in the BVS group and 1 (0.8%) patient in the DES group (P = 0.56).
The use of transradial approach for BVS compared to DES implantation was feasible and safe in all-comers, although BVS implantation included more technical challenges. Outcomes up to 1-year remained comparable in both groups.
经桡动脉途径植入聚合物生物可吸收血管支架（BVS）是否可行且安全尚不清楚。我们比较了经桡动脉途径输送BVS与金属药物洗脱支架（DES）的可行性和安全性。
我们纳入了118例连续接受BVS植入的患者，并将其30天和1年的结果与118例匹配的DES患者进行比较。患者在年龄、性别、危险因素和临床适应症方面进行了匹配。
BVS组经桡动脉途径的比例为98%，DES组为95%（P = 0.16），分别有38%和32%使用5Fr导管（P = 0.34）。两组支架数量相似，分别为2.6±1.5和2.4±1.3（P = 0.23）。尽管两组支架植入的最大压力相同（16±3个大气压），但BVS组更多病变进行了预扩张（83%对52%，P < 0.001）和后扩张（71%对33%，P < 0.001）。BVS组的造影剂用量（217±97对175±108 ml，P < 0.001）、透视时间（16 [10 - 23]对13 [8 - 21]分钟，P = 0.04）和手术时间（65±31对56±47分钟，P = 0.045）显著更高。两组主要不良心脏事件，包括死亡、心肌梗死和靶血管血运重建情况相似，30天时分别为1.7%对0.8%（P = 0.56），1年时分别为10%对8.5%（P = 0.66）。1年时，BVS组有2例（1.7%）患者发生支架血栓形成，DES组有1例（0.8%）患者发生（P = 0.56）。
与DES植入相比，对所有患者而言，经桡动脉途径植入BVS是可行且安全的，尽管BVS植入存在更多技术挑战。两组1年的结果仍具有可比性。
