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Bioresorbable everolimus-eluting vascular scaffold in patients with ST-segment elevation myocardial infarction: Optical coherence tomography evaluation and clinical outcomes
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Abstract
Background: Bioresorbable vascular scaffold (BVS) implantation is a new, promising treatment method of coronary artery disease. Preliminary data in patients with stable angina are encouraging. However, the utility of BVS was not sufficiently evaluated in the setting of acute thrombotic lesions. The aim of this study was an optical coherence tomography (OCT) assessment of acute procedural result of the everolimus-eluting BVS implantation in patients with ST segment elevation myocardial infarction (STEMI) and evaluation of mid-term clinical outcomes.
Methods: OCT examination was conducted in 23 STEMI patients who underwent primary angioplasty with BVS implantation. Off-line qualitative and quantitative coronary angiography and OCT analyses were performed by an independent core laboratory.
Results: Successful procedural and clinical results were achieved in 95.7% of patients, and device success was observed in all patients. In OCT evaluation, most of the struts (95.4 ± ± 7.96%) were well apposed, 4.6 ± 5.71% were classified as malapposed. The final minimum lumen diameter was 2.6 ± 0.35 mm, minimum scaffold area was 6.9 ± 1.54 mm2 and final residual stenosis was 8.8 ± 24.37%. Edge dissections were found in 3 (7.7%) lesions. Median follow-up period was 229 (interquartile range 199–248) days. One myocardial infarction, due to sub-acute stent thrombosis, occurred in a patient who discontinued pharmacotherapy.
Conclusions: The study shows that everolimus-eluting BVS implantation in STEMI is safe and feasible. The OCT evaluation confirmed excellent acute performance with appropriate scaffold expansion and low rate of malapposition.
Abstract
Background: Bioresorbable vascular scaffold (BVS) implantation is a new, promising treatment method of coronary artery disease. Preliminary data in patients with stable angina are encouraging. However, the utility of BVS was not sufficiently evaluated in the setting of acute thrombotic lesions. The aim of this study was an optical coherence tomography (OCT) assessment of acute procedural result of the everolimus-eluting BVS implantation in patients with ST segment elevation myocardial infarction (STEMI) and evaluation of mid-term clinical outcomes.
Methods: OCT examination was conducted in 23 STEMI patients who underwent primary angioplasty with BVS implantation. Off-line qualitative and quantitative coronary angiography and OCT analyses were performed by an independent core laboratory.
Results: Successful procedural and clinical results were achieved in 95.7% of patients, and device success was observed in all patients. In OCT evaluation, most of the struts (95.4 ± ± 7.96%) were well apposed, 4.6 ± 5.71% were classified as malapposed. The final minimum lumen diameter was 2.6 ± 0.35 mm, minimum scaffold area was 6.9 ± 1.54 mm2 and final residual stenosis was 8.8 ± 24.37%. Edge dissections were found in 3 (7.7%) lesions. Median follow-up period was 229 (interquartile range 199–248) days. One myocardial infarction, due to sub-acute stent thrombosis, occurred in a patient who discontinued pharmacotherapy.
Conclusions: The study shows that everolimus-eluting BVS implantation in STEMI is safe and feasible. The OCT evaluation confirmed excellent acute performance with appropriate scaffold expansion and low rate of malapposition.
Keywords
bioresorbable vascular scaffold, optical coherence tomography, ST elevation myocardial infarction, percutaneous coronary interventions
About this articleTitle
Bioresorbable everolimus-eluting vascular scaffold in patients with ST-segment elevation myocardial infarction: Optical coherence tomography evaluation and clinical outcomes
Journal
Issue
Pages
315-322
Published online
2015-06-19
Page views
1877
Article views/downloads
1761
DOI
10.5603/CJ.a2014.0090
Pubmed
Bibliographic record
Cardiol J 2015;22(3):315-322.
Keywords
bioresorbable vascular scaffold
optical coherence tomography
ST elevation myocardial infarction
percutaneous coronary interventions
Authors
Janusz Kochman
Mariusz Tomaniak
Arkadiusz Pietrasik
Łukasz Kołtowski
Adam Rdzanek
Zenon Huczek
Tomasz Mazurek
Jacek Jąkała
Aldona Ząbek
Jacek Legutko
Wacław Kochman
Krzysztof J. Filipiak
