Okamoto Naotaka, Ueda Hiroshi, Yoshimura Takahiro, Chamaria Surbhi, Bhatheja Samit, Vengrenyuk Yuliya, Rabiei Samaneh, Barrientos Yonandy, Kapur Vishal, Barman Nitin, Sweeny Joseph, Baber Usman, Mehran Roxana, Sharma Samin K, Kini Annapoorna S
Mount Sinai Hospital, One Gustave L. Levy Place, Box 1030, New York, NY 10029 USA.
J Invasive Cardiol. 2018 Jul;30(7):251-255. Epub 2018 Apr 15.
The aim of the study was to compare the acute outcomes of Absorb bioresorbable vascular scaffolds (BVS) and second-generation drug-eluting stent (DES) implantation in routine clinical practice. There is a paucity of data regarding BVS use in a real-world patient population.
The study population comprised 40 consecutive patients who underwent percutaneous coronary intervention (PCI) with BVS implantation at a tertiary-care center in New York, New York between July and December of 2016. An optimal implantation technique including adequate lesion preparation, mandatory postdilation, and optical coherence tomography (OCT) imaging was used in all cases. De novo lesions treated with BVS were compared to lesions treated with DES matched by OCT calcium arc, scaffold/stent size, use of atherectomy device, and lesion postdilation. Acute lumen gain, minimal device area, malapposition, eccentricity, and symmetry index were assessed using OCT.
We analyzed OCT images of 40 BVS cases and 40 matching DES cases from 35 and 40 patients, respectively. Compared to the DES group, the BVS group demonstrated similar acute lumen gain, minimal scaffold/stent area, eccentricity index, and symmetry index after PCI. There were fewer malapposed struts detected after BVS implantation; however, malapposition distance and length were not different between the groups.
BVS implantation in a real-world patient population with optimal implantation technique resulted in similar stent expansion and better strut apposition compared to DES implantation.
本研究旨在比较在常规临床实践中，Absorb生物可吸收血管支架（BVS）与第二代药物洗脱支架（DES）植入后的急性疗效。关于在真实患者群体中使用BVS的数据较少。
研究人群包括2016年7月至12月期间在纽约市一家三级医疗中心接受BVS植入经皮冠状动脉介入治疗（PCI）的40例连续患者。所有病例均采用包括充分病变预处理、强制后扩张和光学相干断层扫描（OCT）成像在内的最佳植入技术。将接受BVS治疗的新发病变与接受DES治疗的病变进行比较，这些病变在OCT钙化弧、支架/血管支架尺寸、旋切装置使用情况和病变后扩张方面相匹配。使用OCT评估急性管腔增益、最小装置面积、贴壁不良、偏心度和对称指数。
我们分别分析了来自35例和40例患者的40例BVS病例和40例匹配的DES病例的OCT图像。与DES组相比，BVS组在PCI后表现出相似的急性管腔增益、最小支架/血管支架面积、偏心指数和对称指数。BVS植入后检测到的贴壁不良支柱较少；然而，两组之间的贴壁不良距离和长度并无差异。
在具有最佳植入技术的真实患者群体中植入BVS，与植入DES相比，可实现相似的支架扩张并获得更好的支柱贴壁效果。
