Abstract
BackgroundData on bioresorbable vascular scaffolds (BVS) for the treatment of long lesions are limited. We studied the use of BVS-Absorb in routine clinical practice and compared the outcome of long lesions with short lesions. Implantation of drug-eluting scaffolds without PSP-technique (predilation, proper sizing and postdilation) is associated with an increased thrombotic risk. We compared the long-term outcome up to 36 months of patients with short (< 20 mm) and long (≥20 mm) coronary artery lesions after implantation of bioresorbable vascular scaffolds (BVS) via PSP-technique.MethodsThree hundred twenty-six patients with 424 lesions were enrolled in this prospective study and underwent percutaneous coronary intervention with the Absorb BVS. Clinical follow-up was scheduled after 12, 24 and 36 months. In all lesions the PSP-technique was used. The device oriented composite endpoint (DOCE) was defined as cardiac death, myocardial infarction (MI) not clearly related to a non-target vessel and target lesion revascularization (TLR).ResultsKaplan-Meier estimates for DOCE after 12 months were 2.63% for short lesions and 8.09% for long lesions (p = 0.0131), 5.51% vs. 11.35% (p = 0.0503) after 24 months and 8.00% vs. 18.00% (p = 0.0264) after 36 months of clinical follow-up. Kaplan-Meier estimates for TLR after 12 months were 1.46% for short and 7.69% for long lesions (p = 0.0012), 2.06% vs. 8.75% after 24 months (p = 0.0027) and 4.96% vs. 9.59% after 36 months of follow-up (p = 0.0109). Scaffold thrombosis rates were low.ConclusionsIn long lesions compared to short ones the bioresorbable scaffold Absorb implanted with the proper PSP technique Absorb has significant higher rates of DOCE.The Level of EvidenceIs 3 (non-random sample).
Highlights
Data on bioresorbable vascular scaffolds (BVS) for the treatment of long lesions are limited
We Reichart et al BMC Cardiovascular Disorders (2019) 19:22 compared the outcome of long with short lesions treated with the Absorb BVS using the PSP technique with respect to clinical follow-up up to 36 months
The device oriented composite endpoint (DOCE) was defined as the primary outcome measure according to Academic Research Consortium (ARC) criteria [14]
Summary
Data on bioresorbable vascular scaffolds (BVS) for the treatment of long lesions are limited. Prior studies demonstrated a comparable safety and efficacy for the use of bioresorbable scaffolds Absorb in native and simple coronary lesions with a higher rate of thrombotic events like scaffold thrombosis in multiple randomized trials compared to metallic drug eluting stents [1,2,3]. These studies showed that without a consequent use of the renewed PSP-technique the scaffold thrombosis rate as well as clinical endpoints were higher compared to metallic drug-eluting stents [1, 4]. The PSP-technique was used in Reichart et al BMC Cardiovascular Disorders (2019) 19:22 compared the outcome of long with short lesions treated with the Absorb BVS using the PSP technique with respect to clinical follow-up up to 36 months
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