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Torii S, Yamamoto A, Yoshikawa A, Lu L, Sasaki M, Obuchi S, Wada A, Tsukamoto H, Nakazawa G. Degradation of a novel magnesium alloy-based bioresorbable coronary scaffold in a swine coronary artery model. Cardiovasc Interv Ther 2024; 39:428-437. [PMID: 39034338 PMCID: PMC11436393 DOI: 10.1007/s12928-024-01023-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 06/13/2024] [Indexed: 07/23/2024]
Abstract
The objective of the study is to investigate the safety, feasibility, and degradation profile of a novel Mg alloy-based bioresorbable coronary scaffold (JFK-PRODUCT BRS) with thin struts (110 μm). Polymer- or Mg alloy-based BRSs have not replaced nondegradable metal stents because of the higher prevalence of scaffold thrombosis and restenosis in clinical practice; these poor clinical outcomes were due to inadequate scaffold designs, including thick struts (more than 150 μm) and their inappropriate degradation processes. Fourteen healthy pigs received 17 JFK-PRODUCT BRSs in the coronary arteries and were sacrificed at 1, 6, 12, 18, and 26 months after implantation. Angiography, optical coherence tomography, microfocus X-ray computed tomography (µCT), scanning electron microscopy with energy-dispersive X-ray spectrometry (SEM-EDX), and histopathological evaluation were performed. The JFK-PRODUCT had a median percent late recoil of 11.28% at 1 month. The µCT observation confirmed that scaffold discontinuity reached 64.8% at 12 months with increased scaffold inner area thereafter, suggesting artery positive remodeling. The inflammation was mild, peaked at 18 months, and decreased thereafter. The SEM-EDX analysis demonstrated gradual degradation of the scaffold with formation of inorganic deposits, presumed to be calcium phosphates. It also revealed the disappearance of calcium phosphates at 26 months, achieving almost complete replacement of the scaffold by biocomponents. The current study demonstrated the safety and feasibility of JFK-PRODUCT with a lower acute recoil rate despite its thin struts. The scaffolds were almost completely disappeared at 26 months after implantation.
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Affiliation(s)
- Sho Torii
- Department of Cardiology, School of Medicine, Faculty of Medicine, Tokai University, 143 Shimokasuya, Kanagawa, 2591193, Japan
| | - Akiko Yamamoto
- Research Center for Macromolecules and Biomaterials, National Institute for Materials Science, Ibaraki, Japan
| | - Ayako Yoshikawa
- Department of Cardiology, School of Medicine, Faculty of Medicine, Tokai University, 143 Shimokasuya, Kanagawa, 2591193, Japan
| | - Linhai Lu
- Shanghai Kepan Investment and Management CO., LTD, Shanghai, China
| | - Makoto Sasaki
- Faculty of Advanced Science and Technology, Kumamoto University, Kumamoto, Japan
| | - Shoko Obuchi
- Japan Medical Device Technology Co., Ltd, Kumamoto, Japan
| | - Akira Wada
- Japan Medical Device Technology Co., Ltd, Kumamoto, Japan
| | | | - Gaku Nakazawa
- Department of Cardiology, Faculty of Medicine, Kindai University, Osaka, Japan.
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Latsios G, Koliastasis L, Toutouzas K, Tsioufis K. Recognizing and preventing complications regarding bioresorbable scaffolds during coronary interventions. World J Cardiol 2024; 16:508-511. [PMID: 39351339 PMCID: PMC11439101 DOI: 10.4330/wjc.v16.i9.508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2024] [Revised: 08/30/2024] [Accepted: 09/06/2024] [Indexed: 09/19/2024] Open
Abstract
The evolution of coronary intervention techniques and equipment has led to more sophisticated procedures for the treatment of highly complex lesions. However, as a result, the risk of complications has increased, which are mostly iatrogenic and often include equipment failure. Stent dislodgement warrants vigilance for the early diagnosis and a stepwise management approach is required to either expand or retrieve the lost stent. In the era of bioresorbable scaffolds that are not radiopaque, increased caution is required. Intravascular imaging may assist in detecting the lost scaffold in cases of no visibility fluoroscopically. Adequate lesion preparation is the key to minimizing the possibility of equipment loss; however, in the case that it occurs, commercially available and improvised devices and techniques may be applied.
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Affiliation(s)
- George Latsios
- Department of Cardiology, Hippokration General Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece.
| | - Leonidas Koliastasis
- Department of Cardiology, Hippokration General Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Konstantinos Toutouzas
- Department of Cardiology, Hippokration General Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
| | - Kostas Tsioufis
- Department of Cardiology, Hippokration General Hospital, Athens Medical School, National and Kapodistrian University of Athens, Athens 11527, Greece
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Seguchi M, Baumann-Zumstein P, Fubel A, Pritsch M, Aytekin A, Nicol P, Altevogt J, Joner M. Optical coherence tomography characterization of degradation kinetics between second- and third-generation resorbable magnesium scaffold. Catheter Cardiovasc Interv 2024. [PMID: 39314044 DOI: 10.1002/ccd.31238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Revised: 08/12/2024] [Accepted: 09/12/2024] [Indexed: 09/25/2024]
Abstract
AIMS This preclinical study aimed to establish optical coherence tomography (OCT)-derived parameters that could be used in the clinical setting for assessing strut degradation in the third-generation drug-eluting resorbable magnesium scaffold (DREAMS-3G), and characterize the comparative degradation profile against its precursor device (MagmarisTM scaffold). METHODS AND RESULTS Twelve DREAMS-3G and 10 MagmarisTM scaffolds were implanted in juvenile pigs, and OCT images obtained at baseline and follow-up (6 or 12 months). Strut degradation was assessed by planimetric analysis and compared with OCT-derived indices to validate their diagnostic accuracy. A total of 3327 struts of DREAMS-3G and 2995 struts of the MagmarisTM scaffold were delineated by OCT. DREAMS-3G exhibited a significantly higher number of visible struts per analyzed frame at 6 months than the MagmarisTM scaffold, in the absence of significant differences at 12 months. Attenuation index (AtI) analysis indicated DREAMS-3G degradation was less advanced at 6 months but more advanced at 12 months compared to the MagmarisTM scaffold. These OCT-derived indices significantly correlated with the results of the planimetric analysis. CONCLUSION The current preclinical study validated OCT indices that may serve as clinical surrogate markers for scaffold degradation. AtI analysis indicated that DREAMS-3G showed less degradation at 6 months but more advanced degradation at 12 months compared to the MagmarisTM scaffold, which corroborates the findings from planimetric analysis.
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Affiliation(s)
- Masaru Seguchi
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
- Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, Saitama, Japan
| | | | - Armin Fubel
- Device Discovery & Preclinical Affairs, Biotronik AG, Bülach, Switzerland
| | - Martin Pritsch
- Device Discovery & Preclinical Affairs, Biotronik AG, Bülach, Switzerland
| | - Alp Aytekin
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Philipp Nicol
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Jonas Altevogt
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Michael Joner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
- Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
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4
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Seguchi M, Aytekin A, Xhepa E, Haude M, Wlodarczak A, van der Schaaf RJ, Torzewski J, Ferdinande B, Escaned J, Iglesias JF, Bennett J, Toth GG, Toelg R, Wiemer M, Olivecrona G, Vermeersch P, Waksman R, Garcia-Garcia HM, Joner M. Vascular response following implantation of the third-generation drug-eluting resorbable coronary magnesium scaffold: an intravascular imaging analysis of the BIOMAG-I first-in-human study. EUROINTERVENTION 2024; 20:e1173-e1183. [PMID: 39279514 PMCID: PMC11384225 DOI: 10.4244/eij-d-24-00055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Abstract
BACKGROUND The 12-month outcomes of BIOMAG-I - the first-in-human study investigating the third-generation drug-eluting resorbable magnesium scaffold (DREAMS 3G) - showed promising results regarding clinical outcomes and late lumen loss. AIMS The current study aimed to investigate vascular healing parameters assessed by optical coherence tomography (OCT) and intravascular ultrasound (IVUS), focusing on strut visibility, vessel and scaffold areas, and neointimal growth patterns. METHODS This is a BIOMAG-I substudy including patients with available serial OCT and IVUS data. We conducted a frame-based analysis of OCT findings in conjunction with IVUS-derived vessel and scaffold areas, evaluating the qualitative and quantitative aspects of vascular healing. RESULTS Among the 116 patients enrolled in this trial, 56 patients treated with DREAMS 3G were included in the analysis. At 12 months, OCT imaging revealed that 99.0% of the struts were invisible, and no malapposed struts were depicted. While the vessel area showed no significant difference between the timepoints, the minimum lumen area significantly decreased from post-percutaneous coronary intervention to 6 months (6.88 mm2 to 4.75 mm2; p<0.0001), but no significant changes were observed between 6 and 12 months. Protruding neointimal tissue (PNT) - a unique neointimal presentation observed following resorbable magnesium scaffold implantation - was observed in 89.3% of the study patients at 12 months, and its area exhibited a 47.4% decrease from 6 to 12 months. CONCLUSIONS This imaging substudy revealed that, at 12-month follow-up, virtually all struts of the DREAMS 3G scaffold became invisible, without evident malapposition. The vascular healing response to DREAMS 3G implantation also appeared favourable up to 12 months, which is indicated by advanced strut degradation and spontaneous regressing PNT between 6 and 12 months.
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Affiliation(s)
- Masaru Seguchi
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Alp Aytekin
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Erion Xhepa
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
| | - Michael Haude
- Department of Cardiology, Rheinland Klinikum Neuss, Neuss, Germany
| | - Adrian Wlodarczak
- Department of Cardiology, Miedziowe Centrum Zdrowia S.A., Lubin, Poland
| | | | - Jan Torzewski
- Cardiovascular Center Oberallgäu-Kempten, Kempten, Germany
| | - Bert Ferdinande
- Department of Cardiology, Ziekenhuis Oost Limburg (ZOL), Genk, Belgium
| | - Javier Escaned
- Division of Cardiology, Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, CIBERCV, Madrid, Spain
| | - Juan F Iglesias
- Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Johan Bennett
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Gabor G Toth
- Division of Cardiology, Medical University Graz, Graz, Austria
| | - Ralph Toelg
- Cardiology Department, Heart Center Segeberger Kliniken, Bad Segeberg, Germany
- Medical Faculty of the Christian-Albrechts-University of Kiel, Kiel, Germany
- Center for Cardiovascular and Diabetes Medicine, Asklepios Clinic Bad Oldesloe, Bad Oldesloe, Germany
| | - Marcus Wiemer
- Department of Cardiology and Intensive Care, Johannes Wesling University Hospital, Ruhr University Bochum, Minden, Germany
| | - Göran Olivecrona
- Department of Cardiology, Skåne University Hospital, Lund, Sweden
| | | | - Ron Waksman
- Interventional Cardiology, MedStar Washington Hospital Center, Washington, D.C., USA
| | | | - Michael Joner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technical University Munich, Munich, Germany
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Räber L, Kakizaki R. Serial intracoronary imaging to predict efficacy and safety of magnesium-based resorbable scaffolds. EUROINTERVENTION 2024; 20:e1124-e1126. [PMID: 39279520 PMCID: PMC11384223 DOI: 10.4244/eij-e-24-00044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2024]
Affiliation(s)
- Lorenz Räber
- Department of Cardiology, Bern University Hospital, Inselspital, University of Bern, Bern, Switzerland
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6
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Haude M, Iglesias JF, Garcia-Garcia HM, Barlagiannis D, Degrauwe S, Melaku G, Beyene S, Waksman R. A new resorbable magnesium scaffold (DREAMS 3G): 12-month vasomotion results from the BIOMAG-I first-in-human study. EUROINTERVENTION 2024; 20:e1118-e1120. [PMID: 39219359 PMCID: PMC11352512 DOI: 10.4244/eij-d-24-00355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 05/21/2024] [Indexed: 09/04/2024]
Affiliation(s)
- Michael Haude
- Medical Clinic I, Rheinland Klinikum Neuss GmbH, Lukaskrankenhaus, Neuss, Germany
| | - Juan F Iglesias
- Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | | | | | - Sophie Degrauwe
- Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Gebremedhin Melaku
- Interventional Cardiology, MedStar Washington Hospital Center, Washington, D.C., USA
| | - Solomon Beyene
- Interventional Cardiology, MedStar Washington Hospital Center, Washington, D.C., USA
| | - Ron Waksman
- Interventional Cardiology, MedStar Washington Hospital Center, Washington, D.C., USA
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7
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Song L, Guan C, Yu M, Sun Z, Fu G, He Y, Jia S, Chen J, Qi F, Bai J, Li W, Ge J, Han Y, Gao R. Sirolimus-eluting iron bioresorbable scaffold versus cobalt-chromium everolimus-eluting stents in patients with coronary artery disease: Rationale and design of the IRONMAN-II trial. Am Heart J 2024; 275:53-61. [PMID: 38838969 DOI: 10.1016/j.ahj.2024.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/30/2024] [Accepted: 05/31/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND The previous first-in-human study established the preliminary safety and effectiveness of the novel thin-strut iron bioresorbable scaffold (IBS). The current study aims to directly compare the imaging and physiological efficacy, and clinical outcomes of IBS with contemporary metallic drug-eluting stents (DES). METHODS A total of 518 patients were randomly allocated to treatment with IBS (257 patients) or metallic DES (261 patients) from 36 centers in China. The study is powered to test noninferiority of the IBS compared with the metallic everolimus-eluting stent in terms of the primary endpoint of in-segment late lumen loss at 2 years, and major secondary endpoints including 2-year quantitative flow ratio and cross-sectional mean flow area measured by optical coherence tomography (OCT) (limited to the OCT subgroup, 25 patients in each group). CONCLUSION This will be the first powered randomized trial investigating the safety and efficacy of the novel thin-strut IBS compared to a contemporary metallic DES. The findings will provide valuable evidence for future research of this kind and the application of metallic bioresorbable scaffolds.
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Affiliation(s)
- Lei Song
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; National Clinical Research Center for Cardiovascular Diseases, Beijing, China; Catheterization Laboratories, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Changdong Guan
- Catheterization Laboratories, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mengyue Yu
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiology, Fuwai Yunan hospital, Chinese Academy of Medical Sciences, Kunming, China
| | - Zhongwei Sun
- Catheterization Laboratories, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Guosheng Fu
- Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yong He
- Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China
| | - Shaobin Jia
- Department of Cardiology, General Hospital of Ningxia Medical University, Yinchuan, China
| | - Jiyan Chen
- Department of Cardiology, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Feng Qi
- Department of Cardiology, Fuwai Yunan hospital, Chinese Academy of Medical Sciences, Kunming, China
| | - Jie Bai
- Department of Cardiology, Fuwai Yunan hospital, Chinese Academy of Medical Sciences, Kunming, China
| | - Wei Li
- Medical Research and Biometrics Center, National Center for Cardiovascular Diseases, Beijing, China
| | - Junbo Ge
- Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Disease, Shanghai, China
| | - Yaling Han
- Cardiovascular Research Institute and Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, China
| | - Runlin Gao
- Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardiology, Fuwai Yunan hospital, Chinese Academy of Medical Sciences, Kunming, China.
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Miyashita K, Ninomiya K, Tobe A, Masuda S, Kotoku N, Kageyama S, Revaiah PC, Tsai TY, Wang B, Garg S, Serruys PW, Onuma Y. Long-term outcomes following bioresorbable vascular scaffolds. Expert Rev Cardiovasc Ther 2024; 22:391-407. [PMID: 39049728 DOI: 10.1080/14779072.2024.2375340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 02/20/2024] [Accepted: 06/28/2024] [Indexed: 07/27/2024]
Abstract
INTRODUCTION The higher scaffold thrombosis rates observed with the first-generation bioresorbable scaffolds (BRSs) compared to conventional drug-eluting stents were likely due in part to bioresorbable polymers having insufficient radial strength, necessitating larger strut profiles. Meta-analysis of the long-term outcomes from the first-generation Absorb bioresorbable vascular scaffold (BVS) showed that this period of excess risk ended at 3 years. Therefore, current attention has been focused on improving early outcomes by increasing the scaffold's tensile strength and reducing strut thickness. AREAS COVERED This review summaries the lessons learned from the first-generation BRS. It updates the long-term clinical outcomes of trials evaluating the ABSORB BVS and metallic alloy-based BRS. In addition, it reviews the next-generation BRSs manufactured in Asia. EXPERT OPINION Critical areas to improve the performance and safety of biodegradable scaffolds include further development in material science, surface modification, delivery systems, and long-term follow-up studies.
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Affiliation(s)
- Kotaro Miyashita
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Kai Ninomiya
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Akihiro Tobe
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Shinichiro Masuda
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Nozomi Kotoku
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Shigetaka Kageyama
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Pruthvi C Revaiah
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Tsung-Ying Tsai
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Bo Wang
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Scot Garg
- Department of Cardiology, Royal Blackburn Hospital, Blackburn, UK
| | - Patrick W Serruys
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
| | - Yoshinobu Onuma
- The College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- CORRIB Research Centre for Advanced Imaging and Core laboratory, University of Galway, Galway, Ireland
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Koliastasis L, Bennett J, Xaplanteris P, Skalidis I, Guédès A, Demeure F, Vandeloo B, Dugauquier C, Picard F, Warne DW, Pilgrim T, Iglesias JF, de Hemptinne Q. Two-year clinical outcomes of resorbable magnesium scaffold versus conventional drug-eluting stents in ST-segment elevation myocardial infarction: A propensity score matching analysis. Hellenic J Cardiol 2024; 78:84-86. [PMID: 38134970 DOI: 10.1016/j.hjc.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 12/20/2023] [Indexed: 12/24/2023] Open
Affiliation(s)
- Leonidas Koliastasis
- Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Johan Bennett
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Panagiotis Xaplanteris
- Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Ioannis Skalidis
- Department of Cardiology, University Hospital of Lausanne, Lausanne, Switzerland
| | - Antoine Guédès
- CHU UCL Namur, Site de Mont Godinne, Université Catholique de Louvain, Belgium
| | - Fabian Demeure
- CHU UCL Namur, Site de Mont Godinne, Université Catholique de Louvain, Belgium
| | - Bert Vandeloo
- Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZB), Department of Cardiology, Brussels, Belgium
| | | | - Fabien Picard
- Hôpital Cochin, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - David W Warne
- Research Center for Statistics, Geneva School of Economics and Management, University of Geneva, Switzerland
| | - Thomas Pilgrim
- Department of Cardiology, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Juan F Iglesias
- Department of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Quentin de Hemptinne
- Department of Cardiology, CHU Saint-Pierre, Université Libre de Bruxelles, Brussels, Belgium.
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10
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Muramatsu T, Onuma Y, Serruys PW. Bioresorbable Scaffolds - A Ray of Hope in the Darkness. Circ J 2024; 88:873-875. [PMID: 38631863 DOI: 10.1253/circj.cj-24-0219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Affiliation(s)
- Takashi Muramatsu
- Department of Cardiology, Cardiovascular Center, Fujita Health University Hospital
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11
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Garcia-Garcia HM, Waksman R, Melaku GD, Garg M, Beyene S, Wlodarczak A, Kerai A, Levine MB, van der Schaaf RJ, Torzewski J, Ferdinande B, Escaned J, Iglesias JF, Bennett J, Toth GG, Joner M, Toelg R, Wiemer M, Olivecrona G, Vermeersch P, Haude M. Temporal changes in coronary plaque as assessed by an artificial intelligence-based optical coherence tomography: from the first-in-human trial on DREAMS 3G scaffold. Eur Heart J Cardiovasc Imaging 2024; 25:491-497. [PMID: 37936296 DOI: 10.1093/ehjci/jead299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 10/06/2023] [Accepted: 10/15/2023] [Indexed: 11/09/2023] Open
Abstract
AIMS The aim of the study is to assess the impact of the baseline plaque composition on the DREAMS 3G luminal late loss and to compare the serial plaque changes between baseline and 6 and 12 months (M) follow-up. METHODS AND RESULTS A total of 116 patients were enrolled in the BIOMAG-I trial. Patients were imaged with optical coherence tomography (OCT) pre- and post-DREAMS 3G implantation and at 6 and 12 M. OCTPlus software uses artificial intelligence to assess composition (i.e. lipid, calcium, and fibrous tissue) of the plaque. The differences between the OCT-derived minimum lumen area (MLA) post-percutaneous coronary intervention and 12 M were grouped into three terciles. Patients with larger MLA differences at 12 M (P = 0.0003) had significantly larger content of fibrous tissue at baseline. There was a reduction of 24.8% and 20.9% in lipid area, both P < 0.001, between the pre-DREAMS 3G OCT and the 6 and 12 M follow-up. Conversely, the fibrous tissue increased by 48.4% and 36.0% at 6 and 12 M follow-up, both P < 0.001. CONCLUSION The larger the fibrous tissue in the lesion at baseline, the larger the luminal loss seen at 6 and 12 M. Following the implantation of DREAMS 3G, favourable healing of the vessel coronary wall occurs as shown by a decrease in the lipid area and an increase in fibrous tissue.
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Affiliation(s)
- Hector M Garcia-Garcia
- Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street NW, Suite 4B-1, Washington, DC 20010, USA
| | - Ron Waksman
- Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street NW, Suite 4B-1, Washington, DC 20010, USA
| | - Gebremedhin D Melaku
- Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street NW, Suite 4B-1, Washington, DC 20010, USA
| | - Mohil Garg
- Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street NW, Suite 4B-1, Washington, DC 20010, USA
| | - Solomon Beyene
- Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street NW, Suite 4B-1, Washington, DC 20010, USA
| | - Adrian Wlodarczak
- Department of Cardiology, Miedziowe Centrum Zdrowia SA, Lubin, Poland
| | - Ajay Kerai
- Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street NW, Suite 4B-1, Washington, DC 20010, USA
| | - Molly B Levine
- Interventional Cardiology, MedStar Washington Hospital Center, 110 Irving Street NW, Suite 4B-1, Washington, DC 20010, USA
| | | | - Jan Torzewski
- Cardiovascular Center Oberallgäu-Kempten, Kempten, Germany
| | - Bert Ferdinande
- Department of Cardiology, Ziekenhuis Oost Limburg (ZOL), Genk, Belgium
| | - Javier Escaned
- Division of Cardiology, Hospital Clinico San Carlos IDISSC, Complutense University of Madrid, Madrid, Spain
| | - Juan F Iglesias
- Cardiology Division, University Hospital of Geneva, Geneva, Switzerland
| | - Johan Bennett
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Gabor G Toth
- Division Cardiology, Medical University Graz, Graz, Austria
| | - Michael Joner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, München, Germany
- Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Ralph Toelg
- Cardiology Department, Heart Center Segeberger Kliniken, Bad Segeberg, Germany
| | - Marcus Wiemer
- Department of Cardiology and Intensive Care, Johannes Wesling University Hospital, Ruhr University Bochum, Minden, Germany
| | - Göran Olivecrona
- Department of Cardiology, Skane University Hospital, Lund, Sweden
| | - Paul Vermeersch
- Interventional Cardiology, ZNA Middelheim, Antwerpen, Belgium
| | - Michael Haude
- Medical Clinic I, Rheinland Klinikum Neuss GmbH, Lukaskrankenhaus, Neuss, Germany
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Serruys PW, Revaiah PC. The American Heart Association's Centennial and Percutaneous Coronary Intervention's Semi-Centennial. Circulation 2024; 149:973-978. [PMID: 38527128 DOI: 10.1161/circulationaha.123.064461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Affiliation(s)
- Patrick W Serruys
- Cardiovascular Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Ireland
| | - Pruthvi C Revaiah
- Cardiovascular Research Centre for Advanced Imaging and Core Laboratory, University of Galway, Ireland
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Bennett J, Desmet W, Dubois C. The COBRA II (COmplex Bifurcation lesions: RAndomized comparison of a fully bioresorbable modified-T stenting strategy versus bifurcation reconstruction with a dedicated self-expanding stent in combination with bioresorbable scaffolds) study: Final 5-year follow-up. Indian Heart J 2023; 75:473-476. [PMID: 37739221 PMCID: PMC10774576 DOI: 10.1016/j.ihj.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 09/19/2023] [Indexed: 09/24/2023] Open
Abstract
BACKGROUND In order to advocate further research in bioresorbable scaffold (BVS) technology we report the final 5-year outcomes of the COBRA II study, the only randomized controlled trial (RCT) performed to investigate the safety, feasibility, and performance of Absorb BVS (Abbott Vascular) in true coronary bifurcations. METHODS COBRA II was a prospective single-center RCT. Fifteen patients with true coronary bifurcation lesions were randomized to bifurcation treatment with self-expanding biolimus-eluting Axxess bifurcation device (Biosensors International) combined with additional bioresorbable everolimus-eluting Absorb BVS in the bifurcation branches on (Axxess group) or to 2-stent mod-T stenting technique with Absorb BVS (mod-T group). Optical coherence tomography was performed post-procedure and at 30-months. The primary endpoint was change in minimal luminal area (MLA) on OCT from baseline to 30-months. RESULTS Fifteen patients with coronary bifurcation lesions were randomized to the Axxess group (n = 8) or Modified-T group (n = 7). At 30 months, MLAs were significantly smaller than post-procedure in the majority of bifurcation segments treated with BVS due to neointima formation, while MLAs in the proximal Axxess segment remained stable (primary endpoint). Five-year clinical follow-up was available for all patients. Only 1 major adverse cardiac event occurred; a patient underwent target lesion revascularization at 30 months in the Axxess group. There were no cases of cardiac death, spontaneous MI, or stent/scaffold thrombosis. CONCLUSIONS In this small RCT bifurcation study, BVS luminal dimensions were significantly smaller at 30 months, with acute strut discontinuities and late Intraluminal dismantling frequently observed, although acceptable clinical outcomes were noted at 5 years.
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Affiliation(s)
- Johan Bennett
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium.
| | - Walter Desmet
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Christophe Dubois
- Department of Cardiovascular Medicine, University Hospitals Leuven, Leuven, Belgium; Department of Cardiovascular Sciences, Katholieke Universiteit Leuven, Leuven, Belgium
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