Long-term invasive follow-up of bioresorbable vascular scaffold: Optical Coherence Tomography assessment of jailed side branches

Cardiovasc Revasc Med. 2018 Apr;19(3 Pt A):279-285. doi: 10.1016/j.carrev.2017.09.001. Epub 2017 Sep 10.

Abstract

Background: Little is known about the long term development of the tissue bridges covering the struts of bioresorbable vascular scaffold (BVS) at the side branches (SB) ostium. This study aims at assessing the resorption process of jailed SB after BVS implantation.

Methods: We performed both Optical Coherence Tomography (OCT) and Intravascular Ultrasound (IVUS) analysis of 7 patients enrolled in the ABSORB Cohort B trial at our center. Orifice SB area and mean thickness of tissue bridge covering SB were calculated from 2D assessment. The number of SB orifice compartments separated by BRS struts was analysed by using 3D OCT reconstruction.

Results: At 5years follow-up, no struts could be identified. Between 3 and 5years, both lesion-level and cross section-level OCT findings showed a significant increase in Mean lumen area (MLA) (4.67±1.66mm2 vs. 5.57±1.57mm2; p=0.04) as well as Minimum Lumen Area (MinLA) (5.98±1.98mm2 vs. 6.73±1.87mm2; p=0.04). Moreover, eccentricity index showed a significant reduction between 3 and 5years (0.28±0.35mm2 vs. 0.16±0.06mm2; p=0.04). We identified a total of 3 SBs ostia in the segments treated with BVS. Between 3 and 5years follow-up in all SB analysed, we detected a decrease of mean tissue bridge thickness and an increase of calculated SBs area.

Conclusions: In our serial OCT, a significant decrease of tissue bridge formation together with SB orifice area enlargement from 3 to 5year follow-up has been proved.

Keywords: Bifurcation lesions; Bioresorbable scaffold; Optical coherence tomography.

MeSH terms

  • Absorbable Implants*
  • Aged
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / surgery*
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Predictive Value of Tests
  • Prosthesis Design
  • Time Factors
  • Tomography, Optical Coherence*
  • Treatment Outcome
  • Ultrasonography, Interventional