Everolimus-eluting bioresorbable vascular scaffolds implanted in coronary bifurcation lesions: Impact of polymeric wide struts on side-branch impairment

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• 作者：Marcella De Paolis¹ ; Cordula Felix ; Nienke van Ditzhuijzen ; Jiang Ming Fam ; Antonis Karanasos ; Sanneke de Boer ; Nicolas M. van Mieghem ; Joost Daemen ; Francesco Costa ; Luis Carlos Bergoli ; Jurgen M.R. Ligthart ; Evelyn Regar ; Peter P. de Jaegere ; Felix Zijlstra ; Robert Jan van Geuns ; Roberto Diletti ; ¹ ; ^{r.diletti@erasmusmc.nl" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Bifurcations ; Bioresorbable vascular scaffold ; Side-branch ; Quantitative coronary angiography ; Optical coherence tomography
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 October 2016
• 年：2016
• 卷：221
• 期：Complete
• 页码：656-664
• 全文大小：971 K

文摘

Limited data are available on bioresorbable vascular scaffolds (BVS) performance in bifurcations lesions and on the impact of BVS wider struts on side-branch impairment.

Methods

Patients with at least one coronary bifurcation lesion involving a side-branch ≥ 2 mm in diameter and treated with at least one BVS were examined. Procedural and angiographic data were collected and a dedicated methodology for off-line quantitative coronary angiography (QCA) in bifurcation was applied (eleven-segment model), to assess side-branch impairment occurring any time during the procedure. Two- and three-dimensional QCA were used. Optical coherence tomography (OCT) analysis was performed in a subgroup of patients and long-term clinical outcomes reported.

Results

A total of 102 patients with 107 lesions, were evaluated. Device- and procedural-successes were 99.1% and 94.3%, respectively. Side-branch impairment occurring any time during the procedure was reported in 13 bifurcations (12.1%) and at the end of the procedure in 6.5%. Side-branch minimal lumen diameter (Pre: 1.45 ± 0.41 mm vs Final: 1.48 ± 0.42 mm, p = 0.587) %diameter-stenosis (Pre: 26.93 ± 16.89% vs Final: 27.80 ± 15.57%, p = 0.904) and minimal lumen area (Pre: 1.97 ± 0.89 mm² vs Final: 2.17 ± 1.09 mm², p = 0.334), were not significantly affected by BVS implantation. Mean malapposed struts at the bifurcation polygon-of-confluence were 0.63 ± 1.11.

Conclusions

The results of the present investigation suggest feasibility and relative safety of BVS implantation in coronary bifurcations. BVS wide struts have a low impact on side-branch impairment when considering bifurcations with side-branch diameter ≥ 2 mm.