Abstract
BackgroundAdequate expansion is critical to achieve optimal Bioresorbable Vascular Scaffolds (BVS) apposition to the vessel wall. However, compared to metallic stents, BVS present different mechanical properties. Hence, slow deployment and maintenance of balloon inflation for at least 30” is recommended for BVS implantation. However, since no evidences are available demonstrating the superiority of a longer balloon dilatation time, the implantation technique is highly variable among different centers.MethodsA total of 24 BVS-treated lesions were included in the present analysis. After BVS deployment at 12 atmosphere (ATM) the balloon was rapidly deflated and scaffold expansion was documented with an angiogram. The same balloon was then inflated again and kept at 12 ATM for 30”. Finally, a further angiogram was obtained to evaluate BVS expansion. Quantitative coronary angiography (QCA) was performed at each step.ResultsA significant increase of minimal luminal diameter (MLD)-to-reference scaffold diameter (RSD) ratio (MLD to RSD Ration, MR-Ratio) from 0.70 ± 0.10 after initial stent deployment to 0.79 ± 0.10 after the 30”-long balloon dilation was observed (p < 0.001). Of note, this result was consistent across all sub-segments, as well as across almost all lesion subgroups. A substantial reduction in the prevalence of residual stenosis from 29 % to 17 % was registered after the 30”-long dilation.ConclusionsOur results strongly support the maintenance of balloon inflation for at least 30” during BVS deployment to achieve optimal scaffold expansion and minimize the occurrence of residual stenosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s12872-015-0163-5) contains supplementary material, which is available to authorized users.
Highlights
Adequate expansion is critical to achieve optimal Bioresorbable Vascular Scaffolds (BVS) apposition to the vessel wall
In light of the key importance of an optimal implantation technique, and in consideration of the still limited experience with such device, aim of the present studies was to evaluate the influence of a 30"-long balloon inflation on scaffold expansion, in coronary lesions treated with percutaneous angioplasty and implantation of an Absorb
Baseline characteristics A total of 24 consecutive lesions treated whit a BVS (Absorb) in 22 patients from July 2013 to January 2014 fulfilling the inclusion criteria were selected for the present study
Summary
Adequate expansion is critical to achieve optimal Bioresorbable Vascular Scaffolds (BVS) apposition to the vessel wall. Given the Sorrentino et al BMC Cardiovascular Disorders (2015) 15:169 almost doubled strut thickness of BVS compared to metallic scaffolds, it is important to achieve the largest possible luminal area to warrant the best fluido-dynamic conditions and prevent the risk for restenosis and stent thrombosis [10,11,12]. For these reasons, the producer suggests the following implantation protocol: slow BVS release with stepwise balloon inflation going up whit 2 ATM every 5 seconds, until the scaffold is completely expanded. In light of the key importance of an optimal implantation technique, and in consideration of the still limited experience with such device, aim of the present studies was to evaluate the influence of a 30"-long balloon inflation on scaffold expansion, in coronary lesions treated with percutaneous angioplasty and implantation of an Absorb
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