A 12-month angiographic and optical coherence tomography follow-up after bioresorbable vascular scaffold implantation in patients with ST-segment elevation myocardial infarction

• Published in: Catheterization and cardiovascular interventions Vol. 86; no. 4; pp. E180 - E189
• Main Authors: Kochman, Janusz, Tomaniak, Mariusz, Kołtowski, Łukasz, Jąkała, Jacek, Proniewska, Klaudia, Legutko, Jacek, Roleder, Tomasz, Pietrasik, Arkadiusz, Rdzanek, Adam, Kochman, Wacław, Brugaletta, Salvatore, Kaluza, Grzegorz L.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.10.2015; Wiley Subscription Services, Inc
• Subjects: Absorbable Implants; Aged; bioresorbable vascular scaffold; Cohort Studies; Coronary Angiography - methods; Drug-Eluting Stents; Electrocardiography - methods; Female; Follow-Up Studies; Humans; long-term follow-up; Male; Middle Aged; Myocardial Infarction - diagnosis; Myocardial Infarction - therapy; neointima healing process; Observer Variation; optical coherence tomography; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - methods; Prosthesis Failure; Retrospective Studies; Risk Assessment; Severity of Illness Index; ST-segment elevation myocardial infarction; Statistics, Nonparametric; Time Factors; Tissue Scaffolds; Tomography, Optical Coherence - methods; Treatment Outcome; Vascular Patency - physiology; ST-segment elevation myocardial infarction; bioresorbable vascular scaffold; optical coherence tomography; neointima healing process; long-term follow-up
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.26006

Objectives The aim of the study was to evaluate the healing process at 12 months after ABSORB™ bioresorbable vascular scaffold (BVS) implantation in patients with ST‐segment elevation myocardial infarction (STEMI). Background There is currently no data on long‐term BVS performance in the acute thrombotic setting. The underlying altered plaque pathomorphology may impact the neointima healing pattern, potentially making it different to that observed in stable coronary artery disease (CAD). Methods We have performed an angiographic and optical coherence tomography (OCT) 12‐month follow‐up of 19 STEMI patients who were treated with a BVS implantation (23 scaffolds). An independent core laboratory performed a paired analysis of the corresponding frames at baseline and follow‐up. Results At 12 months, the OCT follow‐up showed a decrease in the mean lumen area (8.29 ± 1.53 mm2 vs. 6.82 ± 1.57 mm2, P < 0.001), but no significant change in the mean scaffold area (8.49 ± 1.53 mm2 vs. 8.90 ± 1.51 mm2). Significant decreases in malapposed strut ratio (4.9 ± 8.65% vs. 0.4 ± 1.55%, P < 0.001) and malapposition area (0.29 ± 0.60 mm2 0.08 ± 0.32 mm2, P = 0.002) were observed. A nonhomogenous proliferation of neointima was revealed with a symmetry index of 0.15 (0.08–0.27), a mean neointima thickness of 203 μm (183–249) and mean neointima area of 2.07 ± 0.51 mm2. The quantitative coronary angiography showed late lumen loss of 0.08 ± 0.23 mm and no significant change in the minimal lumen diameter (P = 0.11). There were no major adverse cardiovascular events (MACE), except for one nontarget vessel revascularization. Conclusions The OCT revealed a favorable healing pattern after BVS implantation in a STEMI population. © 2015 Wiley Periodicals, Inc.