Applicability and procedural success rate of bioresorbable vascular scaffolds for percutaneous coronary intervention in an all-comer cohort of 383 consecutive patients

作者：Schlundt Christian; Achenbach Stephan^*; Felten Fabiola; Roether Jens; Marwan Mohamed; Nef Holger; Ludwig Josef; Troebs Monique

来源：Acta Cardiologica, 2017, 72(4): 425-432.

DOI：10.1080/00015385.2017.1307659

• Intervention
• failure
• stent
• absorb
• scaffold

Objectives The purpose of this study was to determine applicability and procedural success of bioresorbable vascular scaffolds (BVS) for percutaneous coronary intervention (PCI) in an all-comer cohort.
Background BVS use in bifurcations and severely calcified lesions is not recommended, and a relatively large crossing profile may cause limitations. It is has never been studied how widely BVS can be applied in all-comer cohorts.
Methods In 383 consecutive patients (acute coronary syndrome: 124, stable coronary disease 259), a BVS (Absorb) was used as first-line device unless any of the following contraindications were present: bifurcation with side branch >2.0 mm, reference diameter <2.5 mm or >4.0 mm, required device length <12 mm, in-stent stenosis, or contraindications to 6 months of DAPT. Patients and lesions were evaluated regarding suitability for BVS treatment, procedural success (successful BVS placement and residual stenosis <30%), and outcome.
Results Of 588 lesions, 303 (52%) were unsuitable for BVS placement due to presence of a bifurcation (30% of unsuitable lesions), reference diameter >4.0 mm (13%) or <2.5 mm (12%), contraindication to 6 months DAPT (13%), in-stent stenosis (14%), and desired device length <12 mm (4%). If BVS use was attempted, procedural success with a scaffold was 95% (271/285). Crossing failure occurred in 14 cases (5%), affected lesions were significantly more calcified. After a mean follow-up period of 259 days, definite/probable scaffold thrombosis occurred in 1.1% of patients.
Conclusions Approximately one-half of lesions in an all-comer population can successfully be treated with BVS. Crossing failure is rare.

• 出版日期2017