1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland.
Kardiol Pol. 2022;80(3):302-306. doi: 10.33963/KP.a2022.0031. Epub 2022 Feb 3.
The data concerning the use of bioresorbable vascular scaffolds (BVS) in coronary bifurcation lesions are limited.
The objective of the study was to evaluate the early and very long-term clinical outcomes of bifurcation stenting with ABSORB BVS.
One hundred consecutive patients with coronary bifurcation lesions treated with BVS were included. A total of 124 BVS were implanted. Provisional side branch stenting was performed in 66 patients, distal main stenting in 14 patients, systematic T stenting in 2, and T with minimal protrusion (TAP) in 5 patients. Side branch ostial stenting was performed in additional 12 patients.
The procedural success was achieved in 98% of patients. In long-term follow-up, the rate of cardiac death was 4.0%, target vessel myocardial infarction was 5.0%, and target vessel revascularization (TVR) was 11%. The cumulative incidence of definite/probable scaffold thrombosis (ST) was 2% at long-term follow-up. Comparison with the historical drug-eluting stents (DES) group revealed higher mortality and major adverse cardiac events rate in the ABSORB group.
Stenting of coronary bifurcation lesions of low-to-moderate complexity with BVS was feasible with good acute performance and acceptable results. However, the risk of death and major adverse cardiovascular events was higher as compared with DES.
关于生物可吸收血管支架（BVS）在冠状动脉分叉病变中应用的数据有限。
本研究旨在评估 ABSORB BVS 分叉支架置入术的早期和极长期临床结果。
纳入 100 例接受 BVS 治疗的冠状动脉分叉病变患者。共植入 124 个 BVS。66 例患者行临时分支支架术，14 例患者行远端主干支架术，2 例行系统 T 支架术，5 例行 T 支架伴最小突出（TAP）术。另外 12 例患者行分支开口支架术。
98%的患者获得了手术成功。长期随访中，心脏死亡发生率为 4.0%，靶血管心肌梗死发生率为 5.0%，靶血管血运重建（TVR）发生率为 11%。长期随访中，确定/可能的支架血栓形成（ST）的累积发生率为 2%。与药物洗脱支架（DES）的历史数据相比，ABSORB 组的死亡率和主要不良心脏事件发生率更高。
低-中度复杂程度的冠状动脉分叉病变用 BVS 支架置入术是可行的，急性效果良好，结果可接受。然而，与 DES 相比，死亡和主要不良心血管事件的风险更高。
