Abstract
BackgroundBioresorbable scaffolds have been introduced to overcome the shortcomings of drug-eluting stents. Higher rates of device thrombosis, however, have been reported up to 3 years after implantation of the Absorb bioresorbable vascular scaffold (BVS). In the current article, we therefore report long-term clinical outcomes of the AMC Absorb Registry.Methods and resultsIn the AMC Absorb Registry, all patients who underwent a percutaneous coronary intervention with Absorb BVS implantation between 30 August 2012 and 5 August 2013 at the Amsterdam University Medical Centre—Academic Medical Centre were included. The composite endpoint of this analysis was target-vessel failure (TVF). The median follow-up of the study cohort of the AMC Absorb Registry was 1534 days. At the time of the cross-sectional data sweep the clinical status at 4 years was known in 124 of 135 patients (91.9%). At long-term follow-up, the composite endpoint of TVF had occurred in 27 patients. The 4‑year Kaplan-Meier estimate of TVF was 19.8%. At 4 years cardiac death had occurred in 4 patients (3.2%) and target-vessel myocardial infarction in 9 (6.9%) patients. Definite scaffold thrombosis occurred in 5 (3.8%) patients. We found 1 case of very late scaffold thrombosis that occurred at 911 days after device implantation in a patient who was not on dual anti-platelet therapy.ConclusionIn a patient population reflecting routine clinical practice, we found that cases of TVF continued to accrue beyond 2 years after Absorb BVS implantation.
Highlights
Coronary bioresorbable scaffolds have been developed to overcome the shortcomings of drug-eluting stents (DES)
In a patient population reflecting routine clinical practice, we found that cases of target-vessel failure (TVF) continued to accrue beyond 2 years after Absorb bioresorbable vascular scaffold (BVS) implantation
Our study provides the first long-term follow-up data on the use of Absorb BVS in a patient population reflecting daily clinical practice with regard to percutaneous coronary intervention
Summary
Coronary bioresorbable scaffolds have been developed to overcome the shortcomings of drug-eluting stents (DES). They are designed to provide temporary coronary scaffolding, in order to prevent acute recoil, and allow for vessel healing, and fully resorb over time [1]. It is the first study that reports long-term follow-up data without a previous intervention in dual anti-platelet therapy (DAPT) strategies (prolonging or re-starting). In this patient population, we found that cases of target-vessel failure continued to accrue beyond 2 years after Absorb BVS implantation. We report long-term clinical outcomes of the AMC Absorb Registry
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More From: Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
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