Roleder Tomasz, Pociask Elzbieta, Wanha Wojciech, Gasior Pawel, Dobrolinska Magdalena, Garncarek Magdalena, Pietraszewski Przemyslaw, Kurzelowski Radoslaw, Smolka Grzegorz, Wojakowski Wojciech
Regional Specialist Hospital, Research and Development Center, Wroclaw, Poland.
Department of Biocybernetics and Biomedical Engineering, AGH University of Science and Technology, Krakow, Poland.
Postepy Kardiol Interwencyjnej. 2019;15(2):151-157. doi: 10.5114/aic.2019.86010. Epub 2019 Jun 26.
There are no data presenting a serial assessment of vein graft healing after bioresorbable vascular scaffold (BVS) implantation at long-term follow-up.
To describe ABSORB BVS healing in vein grafts by optical coherence tomography (OCT) and high-definition intravascular imaging (HD-IVUS) at long-term follow-up.Material and methods: The study group consisted of 6 patients. The first patient had serial OCT assessment of BVS implanted in the saphenous vein grafts (SVG) at baseline and at 3-, 6-, 18-month follow-up and the second patient had OCT assessment of BVS implanted in the SVG at baseline and 24-, 48-month follow-up. The second and the third patients had OCT and HD-IVUS imaging at baseline and 48-month follow-up. The last 3 patients had OCT imaging of BVS implanted in the native coronary artery at 48-month follow-up.
There were no differences in neointimal hyperplasia after BVS implantation between each time point. However, complete scaffold coverage was observed only 48 months after implantation. Out of 202 analyzed scaffold struts, there were 67 (33%) black boxes detectable at 48-month follow-up. HD-IVUS presented plaque burden up to 67% at the segment of BVS implantation at 48-months follow-up. There was a difference in neointimal hyperplasia thickness (1.27 (0.953-1.696) vs. 0.757 (0.633-0.848), < 0.001) between a native coronary artery and BVS scaffolds at 48-month follow-up.
Bioresorbable vascular scaffold implanted in SVG characterized moderate neointimal hyperplasia as excessive as compared to native coronary arteries at long-term follow-up. The complete scaffold coverage was observed only 48 months after implantation.
目前尚无关于生物可吸收血管支架（BVS）植入后长期随访静脉移植物愈合情况的系列评估数据。
通过光学相干断层扫描（OCT）和高清血管内成像（HD-IVUS）描述静脉移植物中BVS在长期随访中的愈合情况。材料与方法：研究组包括6例患者。首例患者在基线时以及随访3个月、6个月、18个月时对植入大隐静脉移植物（SVG）的BVS进行系列OCT评估，第二例患者在基线时以及随访24个月、48个月时对植入SVG的BVS进行OCT评估。第二例和第三例患者在基线时以及随访48个月时进行OCT和HD-IVUS成像。最后3例患者在随访48个月时对植入自身冠状动脉的BVS进行OCT成像。
各时间点BVS植入后内膜增生无差异。然而，仅在植入后48个月观察到支架完全覆盖。在202个分析的支架支柱中，随访48个月时可检测到67个（33%）黑匣子。HD-IVUS显示在随访48个月时BVS植入节段的斑块负荷高达67%。随访48个月时，自身冠状动脉与BVS支架之间内膜增生厚度存在差异（1.27（0.953 - 1.696）对0.757（0.633 - 0.848），P < 0.001）。
长期随访显示，植入SVG的生物可吸收血管支架内膜增生程度适中，但与自身冠状动脉相比过度增生。仅在植入后48个月观察到支架完全覆盖。
