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Procedural Predictors for Bioresorbable Vascular Scaffold Thrombosis: Analysis of the Individual Components of the “PSP” Technique

The technique used at the time of implantation has a central role in determining the risk of thrombosis in bioresorbable vascular scaffolds (BRS). Different definitions of the “optimal” implantation technique exist, however. The impact of individual procedural characteristics on the risk of scaffold...

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Autores principales: Dimitriadis, Zisis, Polimeni, Alberto, Anadol, Remzi, Geyer, Martin, Weissner, Melissa, Ullrich, Helen, Münzel, Thomas, Gori, Tommaso
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352132/
https://www.ncbi.nlm.nih.gov/pubmed/30650586
http://dx.doi.org/10.3390/jcm8010093
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author Dimitriadis, Zisis
Polimeni, Alberto
Anadol, Remzi
Geyer, Martin
Weissner, Melissa
Ullrich, Helen
Münzel, Thomas
Gori, Tommaso
author_facet Dimitriadis, Zisis
Polimeni, Alberto
Anadol, Remzi
Geyer, Martin
Weissner, Melissa
Ullrich, Helen
Münzel, Thomas
Gori, Tommaso
author_sort Dimitriadis, Zisis
collection PubMed
description The technique used at the time of implantation has a central role in determining the risk of thrombosis in bioresorbable vascular scaffolds (BRS). Different definitions of the “optimal” implantation technique exist, however. The impact of individual procedural characteristics on the risk of scaffold thrombosis (ScT) was evaluated in a single-center observational study that enrolled 657 patients (79% males, mean age 63 ± 12 years) with 763 lesions who received a total of 925 BRS for de novo lesions. During a median 1076 (762–1206) days’ follow-up there were 28 cases of thrombosis. Independent predictors of ScT included the use of predilatation balloons bigger than the nominal BRS diameter (hazard ratio (HR) = 0.4 (0.16–0.98), p = 0.04), sizing (implantation in vessels with reference vessel diameter >3.5 mm or <2.5 mm: HR = 5.71 (2.32–14.05), p = 0.0002) and the degree of vessel expansion (ratio of minimum lumen to reference vessel diameter, HR: 0.005 (0.0001–0.23), p = 0.007). In addition, a mild BRS oversizing (final BRS diameter to vessel diameter 1.14–1.28) was associated with a lower thrombosis risk, whereas undersizing and more severe oversizing (final BRS diameter to vessel diameter <1.04 and >1.35, respectively) were associated with an increased risk of ScT (HR = 0.13 (0.02–0.59), p = 0.0007). In conclusion, different components of the “optimal” technique have different impacts on the risk of BRS thrombosis. Besides predilatation with a balloon larger than the BRS diameter, correct vessel size selection and a mild to moderate oversizing appear to be protective.
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spelling pubmed-63521322019-02-01 Procedural Predictors for Bioresorbable Vascular Scaffold Thrombosis: Analysis of the Individual Components of the “PSP” Technique Dimitriadis, Zisis Polimeni, Alberto Anadol, Remzi Geyer, Martin Weissner, Melissa Ullrich, Helen Münzel, Thomas Gori, Tommaso J Clin Med Article The technique used at the time of implantation has a central role in determining the risk of thrombosis in bioresorbable vascular scaffolds (BRS). Different definitions of the “optimal” implantation technique exist, however. The impact of individual procedural characteristics on the risk of scaffold thrombosis (ScT) was evaluated in a single-center observational study that enrolled 657 patients (79% males, mean age 63 ± 12 years) with 763 lesions who received a total of 925 BRS for de novo lesions. During a median 1076 (762–1206) days’ follow-up there were 28 cases of thrombosis. Independent predictors of ScT included the use of predilatation balloons bigger than the nominal BRS diameter (hazard ratio (HR) = 0.4 (0.16–0.98), p = 0.04), sizing (implantation in vessels with reference vessel diameter >3.5 mm or <2.5 mm: HR = 5.71 (2.32–14.05), p = 0.0002) and the degree of vessel expansion (ratio of minimum lumen to reference vessel diameter, HR: 0.005 (0.0001–0.23), p = 0.007). In addition, a mild BRS oversizing (final BRS diameter to vessel diameter 1.14–1.28) was associated with a lower thrombosis risk, whereas undersizing and more severe oversizing (final BRS diameter to vessel diameter <1.04 and >1.35, respectively) were associated with an increased risk of ScT (HR = 0.13 (0.02–0.59), p = 0.0007). In conclusion, different components of the “optimal” technique have different impacts on the risk of BRS thrombosis. Besides predilatation with a balloon larger than the BRS diameter, correct vessel size selection and a mild to moderate oversizing appear to be protective. MDPI 2019-01-15 /pmc/articles/PMC6352132/ /pubmed/30650586 http://dx.doi.org/10.3390/jcm8010093 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dimitriadis, Zisis
Polimeni, Alberto
Anadol, Remzi
Geyer, Martin
Weissner, Melissa
Ullrich, Helen
Münzel, Thomas
Gori, Tommaso
Procedural Predictors for Bioresorbable Vascular Scaffold Thrombosis: Analysis of the Individual Components of the “PSP” Technique
title Procedural Predictors for Bioresorbable Vascular Scaffold Thrombosis: Analysis of the Individual Components of the “PSP” Technique
title_full Procedural Predictors for Bioresorbable Vascular Scaffold Thrombosis: Analysis of the Individual Components of the “PSP” Technique
title_fullStr Procedural Predictors for Bioresorbable Vascular Scaffold Thrombosis: Analysis of the Individual Components of the “PSP” Technique
title_full_unstemmed Procedural Predictors for Bioresorbable Vascular Scaffold Thrombosis: Analysis of the Individual Components of the “PSP” Technique
title_short Procedural Predictors for Bioresorbable Vascular Scaffold Thrombosis: Analysis of the Individual Components of the “PSP” Technique
title_sort procedural predictors for bioresorbable vascular scaffold thrombosis: analysis of the individual components of the “psp” technique
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352132/
https://www.ncbi.nlm.nih.gov/pubmed/30650586
http://dx.doi.org/10.3390/jcm8010093
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