Noamen Aymen, Hajlaoui Nadhem, Ben Ayed Houssem, Lahideb Dhaker, Haggui Abdeddayem, Fehri Wafa
Tunis Med. 2019 Nov;97(11):1291-1301.
Bioresorbable scaffold (BRS) is a novel device to treat coronary lesions. It may induce a revolution in percutaneous coronary intervention (PCI) and a novel treatment termed vascular restoration therapy. These devices provide short-term scaffolding of the vessel and then dissolve, which would treat the plaque and coronary lumen without inflicting a permanent foreign body in the coronary artery.
This study sought to describe scaffolding in a cohort of Tunisian coronary diseased patients and assess its immediate and mid-term outcomes.
Twenty nine patients with 42 lesions were enrolled. Mean age was 51.4 years. Mean number of scaffolds per patient was 1.57.
Our population was at high cardiovascular risk cumulating at least 3 risk factors. Most of them presented with an acute coronary syndrome (66.6%). In 76.1% there were type A/B1 lesions. Moderate calcification was present in 42.2%. Bifurcation lesions were present in 21.3% and just one chronic total occlusion was treated. Clinical device success and clinical procedural success were respectively 93.1% and 90.3%.Using Kaplan-Meier methods. At 18 months : - The major adverse cardiac events (MACE) rate was 44.8%. - The probability of survival without target lesion revascularization (TLR) was 59.5%. - Definite or Possible scaffold thrombosis rate was 6.9%. In our study, BRS implantation was associated with a high rate of adverse events in the longer term except in case of IVUS guidance with respect of Predilatation + Sizing + Postdilatation (PSP) protocol.
The theoretical concept of Scaffolding is attractive. One must put into perspective that it is still significantly evolving and improving.
生物可吸收支架（BRS）是一种治疗冠状动脉病变的新型装置。它可能会引发经皮冠状动脉介入治疗（PCI）的一场革命以及一种名为血管修复治疗的新型疗法。这些装置为血管提供短期支撑，然后溶解，从而在不向冠状动脉内植入永久性异物的情况下治疗斑块和冠状动脉管腔。
本研究旨在描述一组突尼斯冠心病患者中支架置入情况，并评估其近期和中期结果。
纳入29例患者的42处病变。平均年龄为51.4岁。每位患者的支架平均数量为1.57个。
我们的研究人群存在较高的心血管风险，累积至少3个风险因素。他们中的大多数表现为急性冠状动脉综合征（66.6%）。76.1%为A/B1型病变。42.2%存在中度钙化。21.3%为分叉病变，仅治疗了1例慢性完全闭塞病变。临床器械成功率和临床操作成功率分别为93.1%和90.3%。使用Kaplan-Meier方法。在18个月时：- 主要不良心脏事件（MACE）发生率为44.8%。- 无靶病变血运重建（TLR）的生存率为59.5%。- 明确或可能的支架血栓形成率为6.9%。在我们的研究中，除了在血管内超声（IVUS）指导下遵循预扩张+尺寸测量+后扩张（PSP）方案外，BRS植入长期来看与较高的不良事件发生率相关。
支架置入的理论概念很有吸引力。必须认识到它仍在显著发展和改进。
