Lack of concordance between angiographic core laboratory and CEC in the assessment of stent thrombosis: results from the TRACER angiographic substudy

Abstract

P244 – Table 1. Adjusted 7 and 30 day outcomes according to heart failure order set use Outcome Odds Ratio (±95% CI) 7 Day Readmission 7 Day Readmission/mortality 30 Day Readmission 30 Day Readmission/Mortality Hospital Length of Stay Order set use 0.67 (0.52–0.87) 0.54 (0.37–0.80) 0.72 (0.57–0.95) 0.79 (0.63–0.99) 0.59 (0.48–0.73) 1.15 to 1.80), full-text publication within 5 years (adjusted OR, 1.49; 95% CI, 1.17 to 1.90), and high citation frequency (adjusted OR, 2.30; 95% CI, 1.31 to 4.04). These findings were largely consistent in a subgroup of abstracts of high-quality, prospective clinical trials. Conclusion: Investigators in less wealthy countries face challenges to disseminate their research, even after accounting for potential differences in the quality of their work and research infrastructure. P246 | BEDSIDE Association between endothelial shear stress and neointimal formation in bioresorbable vascular scaffolds. An OCT study C. Bourantas1, M.I. Papafaklis2, A. Kotsia3, T. Muramatsu1, K.K. Naka3, R. Rapoza4, H.M. Garcia-Garcia1, Y. Onuma1, L.K. Michalis3, P.W. Serruys1 on behalf of ABSORB Cohort B investigators. 1Erasmus Medical Center, Rotterdam, Netherlands; 2Harvard Medical School, Brigham and Women’s Hospital, Boston, United States of America; 3University of Ioannina, Michaelidion Cardiac Center, Department of Cardiology, Ioannina, Greece; 4Abbott Vascular, Santa Clara, United States of America Purpose: Several studies in the past have investigated the association between local endothelial shear stress (ESS) patterns and neointimal formation in bare metal and drug eluting stents. However, no study to date has evaluated the effect of ESS on neointimal development following a bioresorbable scaffold implantation. The aim of this analysis is to investigate the impact of the local hemodynamic environment on neointimal formation following an Absorb bioresorbable vascular scaffold (Absorb BVS) implantation. Methods: Twelve patients with an obstructive lesion in a relatively straight arterial segment who were implanted with an Absorb BVS and investigated with serial optical coherence tomographic examination at baseline and 1 year follow-up were included in the current analysis. The optical coherence tomographic data acquired at follow-up were used to reconstruct the luminal surface of the scaffolded segment at baseline and 1 year follow-up. Blood flow simulation was performed on the luminal surface at baseline defined by the Absorb BVS struts and the ESS was estimated and related to the neointimal thickness measured at 1 year follow-up. Results: Low ESS was noted at baseline, as 61% of the measured ESS were <1Pa. The ESS was higher on the top of the struts and low in between the struts areas where recirculation zones were also seen. The percentage scaffold obstruction at 1 year follow-up was 13.1±6.6% and the mean neointimal thickness was 113±45 μm. A statistically significant correlation was noted in all the studied patients between the logarithmic transformed ESS at baseline and the neointimal thickness at 1 year follow-up (average: -0.451; range: -0.140 to -0.662; P<0.0001). Mixed linear regression analysis between the baseline logarithmic ESS and neointima thickness at follow-up yielded a slope of -31 μm/ln(Pa) and a y-intercept of 99 μm. Conclusions: We found a statistically significant inverse association between ESS and NT in all the studied segments. These findings underscore the role of the local hemodynamic milieu on neointimal response and should be taken into consideration in the design of bioresorbable devices. P247 | BEDSIDE Vascular modelling and wall motion analysis of ascending and descending aorta with 3D-ultrasound speckle tracking and finite element analysis K. Karatolios1, A. Wittek2, C. Blase2, A. Shelke2, R. Moosdorf3 , S. Vogt3. 1University Hospital Giessen and Marburg, Department of Cardiology, Marburg, Germany; 2Institute for Cell Biology and Neuroscience, Goethe-University, Frankfurt, Germany; 3University Hospital Giessen and Marburg, Department of Heart and Vascular Surgery, Marburg, Germany Introduction: Ultrasound imaging techniques have been employed to assess arterial wall motion and deformation, providing important insights in arterial mechanics and related pathologies. Quantifying local deformation and strains of the aorta may yield insight into the changes of biomechanical properties and vascular compliance, which is essential for understanding the pathogenesis and progression of aortic diseases. Methods: Aortic root and abdominal aorta imaging was performed on 10 healthy volunteers with a commercial 3D echocardiography system (Artida, Toshiba Medical Systems, Tokyo, Japan) by means of a 3D transthoracic probe. Aortic wall motion analysis with speckle tracking was performed on the stored 3D raw data by a modified wall motion tracking algorithm with Advance Cardiac Package (Toshiba, UltraExtend). 3D speckle tracking data were then post-processed with a custom written software (Abaqus Viewer 6.10 Simulia, Providence, RI, USA) in order to compute 3D finite element (FE) models of the aortic section and to visualize local strains and displacements. Results: Computed 3D FE models of the imaged segment of the aortic root and abdominal aorta are depicted in figure 1. Strain and 3D displacement curves of by gest on Jne 1, 2016 http://eurhexfordjournals.org/ D ow nladed from