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Feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios

BACKGROUND: Bioresorbable vascular scaffolds (BVS) have become an emerging tool to treat coronary artery disease. However, the current use of BVS is still widely restricted to stable patients and non-complex lesions. In real-world practice patients are far more complex than those with simple type A...

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Autores principales: Jaguszewski, Milosz, Ghadri, Jelena-Rima, Zipponi, Manuel, Bataiosu, Dana Roxana, Diekmann, Johanna, Geyer, Verena, Neumann, Catharina Anna, Huber, Mia Aurelia, Hagl, Christian, Erne, Paul, Lüscher, Thomas F., Templin, Christian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315475/
https://www.ncbi.nlm.nih.gov/pubmed/25173111
http://dx.doi.org/10.1007/s00392-014-0757-4
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author Jaguszewski, Milosz
Ghadri, Jelena-Rima
Zipponi, Manuel
Bataiosu, Dana Roxana
Diekmann, Johanna
Geyer, Verena
Neumann, Catharina Anna
Huber, Mia Aurelia
Hagl, Christian
Erne, Paul
Lüscher, Thomas F.
Templin, Christian
author_facet Jaguszewski, Milosz
Ghadri, Jelena-Rima
Zipponi, Manuel
Bataiosu, Dana Roxana
Diekmann, Johanna
Geyer, Verena
Neumann, Catharina Anna
Huber, Mia Aurelia
Hagl, Christian
Erne, Paul
Lüscher, Thomas F.
Templin, Christian
author_sort Jaguszewski, Milosz
collection PubMed
description BACKGROUND: Bioresorbable vascular scaffolds (BVS) have become an emerging tool to treat coronary artery disease. However, the current use of BVS is still widely restricted to stable patients and non-complex lesions. In real-world practice patients are far more complex than those with simple type A lesions and the extended use of BVS to complex lesions and high-risk patients needs to be evaluated. Therefore, we sought to investigate the feasibility and performance of BVS in a broad spectrum of patients. METHODS: 106 patients underwent in total 193 BVS implantations. We assessed the device-related (cardiac death, target vessel myocardial infarction, ischemia-driven target lesion revascularization) and patient-related (all-cause death, any reinfarction and any revascularization) composite outcomes. RESULTS: 90 % of patients (n = 95) had at least one of the following characteristics: >65 years (35 %), ACS (42 %), tortuous vessels (13 %), calcified (17 %) or thrombotic lesions (12 %), lesions defined as AHA type B2/C (42 %), bifurcations (16 %), chronic total occlusions (9 %) or restenosis (14 %). There was no evidence of significant edge dissection, huge thrombus load or incidence of scaffold dislodgement or scaffold disruption in optical coherence tomography pullbacks. Out of 10,157 struts evaluated within 1,117 cross-sections, 302 were classified as malapposed (2.9 %). During a mean follow-up of 147 ± 119 days the rate of device-related events was 2.0 %, whereas patient-related composite events occurred in 6.1 %. CONCLUSIONS: Our results strongly suggest that BVS implantation is feasible in a wide spectrum of patients and complex anatomy of coronary lesions. Long-term outcome of BVS should be further investigated in unrestricted settings in randomized controlled trials. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00392-014-0757-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-43154752015-02-05 Feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios Jaguszewski, Milosz Ghadri, Jelena-Rima Zipponi, Manuel Bataiosu, Dana Roxana Diekmann, Johanna Geyer, Verena Neumann, Catharina Anna Huber, Mia Aurelia Hagl, Christian Erne, Paul Lüscher, Thomas F. Templin, Christian Clin Res Cardiol Original Paper BACKGROUND: Bioresorbable vascular scaffolds (BVS) have become an emerging tool to treat coronary artery disease. However, the current use of BVS is still widely restricted to stable patients and non-complex lesions. In real-world practice patients are far more complex than those with simple type A lesions and the extended use of BVS to complex lesions and high-risk patients needs to be evaluated. Therefore, we sought to investigate the feasibility and performance of BVS in a broad spectrum of patients. METHODS: 106 patients underwent in total 193 BVS implantations. We assessed the device-related (cardiac death, target vessel myocardial infarction, ischemia-driven target lesion revascularization) and patient-related (all-cause death, any reinfarction and any revascularization) composite outcomes. RESULTS: 90 % of patients (n = 95) had at least one of the following characteristics: >65 years (35 %), ACS (42 %), tortuous vessels (13 %), calcified (17 %) or thrombotic lesions (12 %), lesions defined as AHA type B2/C (42 %), bifurcations (16 %), chronic total occlusions (9 %) or restenosis (14 %). There was no evidence of significant edge dissection, huge thrombus load or incidence of scaffold dislodgement or scaffold disruption in optical coherence tomography pullbacks. Out of 10,157 struts evaluated within 1,117 cross-sections, 302 were classified as malapposed (2.9 %). During a mean follow-up of 147 ± 119 days the rate of device-related events was 2.0 %, whereas patient-related composite events occurred in 6.1 %. CONCLUSIONS: Our results strongly suggest that BVS implantation is feasible in a wide spectrum of patients and complex anatomy of coronary lesions. Long-term outcome of BVS should be further investigated in unrestricted settings in randomized controlled trials. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1007/s00392-014-0757-4) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2014-08-31 2015 /pmc/articles/PMC4315475/ /pubmed/25173111 http://dx.doi.org/10.1007/s00392-014-0757-4 Text en © The Author(s) 2014 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited.
spellingShingle Original Paper
Jaguszewski, Milosz
Ghadri, Jelena-Rima
Zipponi, Manuel
Bataiosu, Dana Roxana
Diekmann, Johanna
Geyer, Verena
Neumann, Catharina Anna
Huber, Mia Aurelia
Hagl, Christian
Erne, Paul
Lüscher, Thomas F.
Templin, Christian
Feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios
title Feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios
title_full Feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios
title_fullStr Feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios
title_full_unstemmed Feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios
title_short Feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios
title_sort feasibility of second-generation bioresorbable vascular scaffold implantation in complex anatomical and clinical scenarios
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315475/
https://www.ncbi.nlm.nih.gov/pubmed/25173111
http://dx.doi.org/10.1007/s00392-014-0757-4
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