Salinas Pablo, Pozo-Osinalde Eduardo, Cerrato Enrico, Garcia-Blas Sergio, Vaudano Giacomo Paolo, Parrilla Cristina, Sanchis Juan, Varbella Ferdinando, Escaned Javier
Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), Madrid, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
Cardiovasc Revasc Med. 2021 Aug;29:18-21. doi: 10.1016/j.carrev.2020.09.004. Epub 2020 Sep 13.
An ancillary advantage of bioresorbable scaffolds is the possibility of non-invasive imaging assessment of the treated coronary segment. Cardiac computed tomography angiography (CCTA) studies of resorbable magnesium scaffolds (RMS) are scarce.
In this collaborative, international study, nine patients who had an RMS implanted underwent CCTA as part of follow-up assessment. Core-lab blinded quantitative and qualitative assessment was performed by an independent CCTA investigator.
Eight studies were amenable for quantitative analysis, and the blinded CT investigator successfully located and evaluated patency of RMS in all cases. The CCTA follow-up in-scaffold percentage diameter stenosis and area stenosis was 22.2% (12.4-30) and 39.1% (0.23-0.50), in keeping with mild in-scaffold late loss and underlying plaque growth. Moreover, a detailed coronary plaque characterization at treated segments was feasible (fibrous plaque in 69.9%, fibrofatty in 17.13%, necrotic in 4.78% and calcium in 5.72%). As in 6 out of 8 cases, the presentation was an acute coronary syndrome, these preliminary results could suggest plaque stabilization and a good coronary vessel healing with RMS.
Non-invasive, follow-up assessment of RMS with CCTA is feasible. Further CCTA studies for either clinical or research purposes with the present and upcoming generation of resorbable magnesium scaffolds are warranted.
生物可吸收支架的一个附带优势是能够对治疗的冠状动脉节段进行非侵入性成像评估。关于可吸收镁支架（RMS）的心脏计算机断层扫描血管造影（CCTA）研究较少。
在这项国际合作研究中，9例植入RMS的患者接受了CCTA检查作为随访评估的一部分。由一名独立的CCTA研究者进行核心实验室盲法定量和定性评估。
8项研究适合进行定量分析，且盲法CT研究者在所有病例中均成功定位并评估了RMS的通畅情况。CCTA随访时支架内直径狭窄百分比和面积狭窄百分比分别为22.2%（12.4 - 30）和39.1%（0.23 - 0.50），与轻度支架内晚期丢失和潜在斑块生长情况相符。此外，对治疗节段进行详细的冠状动脉斑块特征分析是可行的（纤维斑块占69.9%，纤维脂肪斑块占17.13%，坏死斑块占4.78%，钙化斑块占5.72%）。由于8例中有6例表现为急性冠状动脉综合征，这些初步结果可能提示使用RMS可实现斑块稳定和良好的冠状动脉愈合。
使用CCTA对RMS进行非侵入性随访评估是可行的。有必要针对当前及新一代可吸收镁支架开展进一步的CCTA临床或研究性研究。
