Department of Internal Medicine II, University Hospital of Ulm, Ulm, Germany.
Head Interventional Cardiology Research Group, University Hospital of Ulm, Albert-Einstein-Allee, 23 89081, Ulm, Germany.
BMC Cardiovasc Disord. 2019 Jan 18;19(1):22. doi: 10.1186/s12872-018-0994-y.
Data on bioresorbable vascular scaffolds (BVS) for the treatment of long lesions are limited. We studied the use of BVS-Absorb in routine clinical practice and compared the outcome of long lesions with short lesions. Implantation of drug-eluting scaffolds without PSP-technique (predilation, proper sizing and postdilation) is associated with an increased thrombotic risk. We compared the long-term outcome up to 36 months of patients with short (< 20 mm) and long (≥20 mm) coronary artery lesions after implantation of bioresorbable vascular scaffolds (BVS) via PSP-technique.
Three hundred twenty-six patients with 424 lesions were enrolled in this prospective study and underwent percutaneous coronary intervention with the Absorb BVS. Clinical follow-up was scheduled after 12, 24 and 36 months. In all lesions the PSP-technique was used. The device oriented composite endpoint (DOCE) was defined as cardiac death, myocardial infarction (MI) not clearly related to a non-target vessel and target lesion revascularization (TLR).
Kaplan-Meier estimates for DOCE after 12 months were 2.63% for short lesions and 8.09% for long lesions (p = 0.0131), 5.51% vs. 11.35% (p = 0.0503) after 24 months and 8.00% vs. 18.00% (p = 0.0264) after 36 months of clinical follow-up. Kaplan-Meier estimates for TLR after 12 months were 1.46% for short and 7.69% for long lesions (p = 0.0012), 2.06% vs. 8.75% after 24 months (p = 0.0027) and 4.96% vs. 9.59% after 36 months of follow-up (p = 0.0109). Scaffold thrombosis rates were low.
In long lesions compared to short ones the bioresorbable scaffold Absorb implanted with the proper PSP technique Absorb has significant higher rates of DOCE.
Is 3 (non-random sample).
生物可吸收血管支架（BVS）治疗长病变的数据有限。我们研究了在常规临床实践中使用 Absorb BVS-Absorb，并比较了长病变和短病变的结果。不使用 PSP 技术（预扩张、适当的支架尺寸和后扩张）植入药物洗脱支架与血栓形成风险增加相关。我们比较了通过 PSP 技术植入生物可吸收血管支架（BVS）后，短（<20mm）和长（≥20mm）冠状动脉病变患者的 36 个月长期结果。
这项前瞻性研究共纳入 326 例 424 处病变患者，接受 Absorb BVS 经皮冠状动脉介入治疗。临床随访时间分别为 12、24 和 36 个月。所有病变均采用 PSP 技术。定义设备定向复合终点（DOCE）为心脏死亡、与非靶血管无关的心肌梗死（MI）和靶病变血运重建（TLR）。
12 个月时，短病变的 DOCE 估计值为 2.63%，长病变为 8.09%（p=0.0131）；24 个月时，短病变和长病变的 DOCE 分别为 5.51%和 11.35%（p=0.0503），36 个月时分别为 8.00%和 18.00%（p=0.0264）。12 个月时，短病变和长病变的 TLR 估计值分别为 1.46%和 7.69%（p=0.0012）；24 个月时，短病变和长病变的 TLR 分别为 2.06%和 8.75%（p=0.0027）；36 个月时，短病变和长病变的 TLR 分别为 4.96%和 9.59%（p=0.0109）。支架血栓形成率较低。
与短病变相比，在长病变中，采用适当的 PSP 技术植入的生物可吸收支架 Absorb 具有更高的 DOCE 发生率。
3 级（非随机样本）。
