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Tijssen RYG, Annink ME, Kraak RP, Koch KT, Baan J, Vis MM, Piek JJ, Henriques JPS, de Winter RJ, Beijk MAM, Wykrzykowska JJ. The Absorb bioresorbable vascular scaffold in real-world practice: long-term follow-up of the AMC Single Centre Real World PCI Registry. Neth Heart J 2020; 28:153-160. [PMID: 31953774 PMCID: PMC7052095 DOI: 10.1007/s12471-019-01362-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Bioresorbable scaffolds have been introduced to overcome the shortcomings of drug-eluting stents. Higher rates of device thrombosis, however, have been reported up to 3 years after implantation of the Absorb bioresorbable vascular scaffold (BVS). In the current article, we therefore report long-term clinical outcomes of the AMC Absorb Registry. METHODS AND RESULTS In the AMC Absorb Registry, all patients who underwent a percutaneous coronary intervention with Absorb BVS implantation between 30 August 2012 and 5 August 2013 at the Amsterdam University Medical Centre-Academic Medical Centre were included. The composite endpoint of this analysis was target-vessel failure (TVF). The median follow-up of the study cohort of the AMC Absorb Registry was 1534 days. At the time of the cross-sectional data sweep the clinical status at 4 years was known in 124 of 135 patients (91.9%). At long-term follow-up, the composite endpoint of TVF had occurred in 27 patients. The 4‑year Kaplan-Meier estimate of TVF was 19.8%. At 4 years cardiac death had occurred in 4 patients (3.2%) and target-vessel myocardial infarction in 9 (6.9%) patients. Definite scaffold thrombosis occurred in 5 (3.8%) patients. We found 1 case of very late scaffold thrombosis that occurred at 911 days after device implantation in a patient who was not on dual anti-platelet therapy. CONCLUSION In a patient population reflecting routine clinical practice, we found that cases of TVF continued to accrue beyond 2 years after Absorb BVS implantation.
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Affiliation(s)
- R Y G Tijssen
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - M E Annink
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - R P Kraak
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands.,Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, The Netherlands
| | - K T Koch
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - J Baan
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - M M Vis
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - J J Piek
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - J P S Henriques
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - R J de Winter
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - M A M Beijk
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - J J Wykrzykowska
- Department of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, Heart Centre, University of Amsterdam, Amsterdam, The Netherlands.
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Jeżewski MP, Kubisa MJ, Eyileten C, De Rosa S, Christ G, Lesiak M, Indolfi C, Toma A, Siller-Matula JM, Postuła M. Bioresorbable Vascular Scaffolds-Dead End or Still a Rough Diamond? J Clin Med 2019; 8:E2167. [PMID: 31817876 PMCID: PMC6947479 DOI: 10.3390/jcm8122167] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 12/02/2019] [Accepted: 12/04/2019] [Indexed: 02/06/2023] Open
Abstract
Percutaneous coronary interventions with stent-based restorations of vessel patency have become the gold standard in the treatment of acute coronary states. Bioresorbable vascular scaffolds (BVS) have been designed to combine the efficiency of drug-eluting stents (DES) at the time of implantation and the advantages of a lack of foreign body afterwards. Complete resolution of the scaffold was intended to enable the restoration of vasomotor function and reduce the risk of device thrombosis. While early reports demonstrated superiority of BVS over DES, larger-scale application and longer observation exposed major concerns about their use, including lower radial strength and higher risk of thrombosis resulting in higher rate of major adverse cardiac events. Further focus on procedural details and research on the second generation of BVS with novel properties did not allow to unequivocally challenge position of DES. Nevertheless, BVS still have a chance to present superiority in distinctive indications. This review presents an outlook on the available first and second generation BVS and a summary of results of clinical trials on their use. It discusses explanations for unfavorable outcomes, proposed enhancement techniques and a potential niche for the use of BVS.
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Affiliation(s)
- Mateusz P. Jeżewski
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
| | - Michał J. Kubisa
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
| | - Ceren Eyileten
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
| | - Salvatore De Rosa
- Department of Medical and Surgical Sciences, Division of Cardiology, “Magna Graecia” University, 88100 Catanzaro, Italy; (S.D.R.); (C.I.)
| | - Günter Christ
- Department of Cardiology, 5th Medical Department with Cardiology, Kaiser Franz Josef Hospital, 31100 Vienna, Austria;
| | - Maciej Lesiak
- 1st Department of Cardiology, Poznan University of Medical Sciences, 1061701 Poznań, Poland;
| | - Ciro Indolfi
- Department of Medical and Surgical Sciences, Division of Cardiology, “Magna Graecia” University, 88100 Catanzaro, Italy; (S.D.R.); (C.I.)
| | - Aurel Toma
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 231090 Vienna, Austria;
| | - Jolanta M. Siller-Matula
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
- Department of Internal Medicine II, Division of Cardiology, Medical University of Vienna, 231090 Vienna, Austria;
| | - Marek Postuła
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology, Medical University of Warsaw, 02091 Warsaw, Poland; (M.P.J.); (M.J.K.); (C.E.); (M.P.)
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An observational study of clinical outcomes of everolimus-eluting bioresorbable scaffolds comparing the procedural use of optical coherence tomography against angiography alone. Coron Artery Dis 2018; 29:482-488. [DOI: 10.1097/mca.0000000000000626] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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4
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Scaffold thrombosis following implantation of the ABSORB BVS in routine clinical practice: Insight into possible mechanisms from optical coherence tomography. Catheter Cardiovasc Interv 2018; 92:E106-E114. [DOI: 10.1002/ccd.27475] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/28/2017] [Accepted: 11/25/2017] [Indexed: 11/07/2022]
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Cortese B, di Palma G, Cerrato E, Latini RA, Elwany M, Orrego PS, Seregni RG. Clinical and angiographic outcome of a single center, real world population treated with a dedicated technique of implantation for bioresorbable vascular scaffolds. The FAtebenefratelli Bioresorbable Vascular Scaffold (FABS) registry. J Interv Cardiol 2017; 30:427-432. [PMID: 28853189 DOI: 10.1111/joic.12415] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2017] [Revised: 07/03/2017] [Accepted: 07/03/2017] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES With this prospective study we aim at investigating the long-term outcome of a consecutive cohort of patients successfully treated with bioresorbable scaffold (BVS) implantation. BACKGROUND It is not clearly understood if there is a relation between the technique of BVS implantation and the outcome. METHODS Between December 2012 and December 2014, all consecutive patients treated with BVS were included in this registry and received an angiographic follow-up. After a run-in phase, all BVS were implanted using a specific technique consisting of aggressive predilation, correct scaffold sizing, visually determined, and high-pressure post-dilation with a noncompliance balloon. Primary endpoint was late lumen loss (LLL) at 1-year angiographic follow-up and ischemia-driven target-lesion revascularization (ID-TLR) at 2-year clinical follow-up. Secondary endpoints were the occurrence of binary restenosis, major adverse cardiac events (MACE), and every single component of MACE (cardiac death, myocardial infarction, TLR) at 2 years. RESULTS A total of 144 lesions in 122 patients treated consecutively with BVS, were enrolled. Diabetics were 29.5% and acute coronary syndrome at presentation occurred in 29.5% of patients. At the angiographic follow-up LLL was 0.38 ± 0.9. At 2-year clinical follow-up, ID-TLR occurred in eight patients (5.6%). We observed two cases of scaffold thrombosis (1.38%, one early and one very late). At multivariate statistical analysis, STEMI presentation remained a significant predictor for TLR. CONCLUSIONS In a complex, all-comers real world population, BVS implantation with a specific, and standardized technique showed to be feasible, with acceptable mid-term angiographic and long-term clinical outcome.
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Affiliation(s)
- Bernardo Cortese
- Unità Operativa di Cardiologia, ASST Fatebenefratelli-Sacco, Milano, Italy.,Fondazione Monasterio-Regione Toscana-Centro Nazionale delle Ricerche, Pisa and Massa, Italy
| | - Gaetano di Palma
- Unità Operativa di Cardiologia, ASST Fatebenefratelli-Sacco, Milano, Italy.,Division of Cardiology, Cardio-thoracic and Respiratory Sciences Department, Second University of Naples, AO Dei Colli-Monaldi Hospital, Naples, Italy
| | - Enrico Cerrato
- San Luigi Gonzaga University Hospital, Orbassano (Turin), Italy
| | - Roberto A Latini
- Unità Operativa di Cardiologia, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Mostafa Elwany
- Unità Operativa di Cardiologia, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Pedro S Orrego
- Unità Operativa di Cardiologia, ASST Fatebenefratelli-Sacco, Milano, Italy
| | - Romano G Seregni
- Unità Operativa di Cardiologia, ASST Fatebenefratelli-Sacco, Milano, Italy
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Cassese S, Kastrati A, Fusaro M. Bioresorbable vascular scaffolds for complex coronary anatomies: "Icarus' flight" for interventional cardiologists? Cardiovasc Diagn Ther 2017; 7:S98-S101. [PMID: 28748158 DOI: 10.21037/cdt.2017.01.10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Salvatore Cassese
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Adnan Kastrati
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Massimiliano Fusaro
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
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Polimeni A, Anadol R, Münzel T, Indolfi C, De Rosa S, Gori T. Long-term outcome of bioresorbable vascular scaffolds for the treatment of coronary artery disease: a meta-analysis of RCTs. BMC Cardiovasc Disord 2017; 17:147. [PMID: 28592227 PMCID: PMC5463321 DOI: 10.1186/s12872-017-0586-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/01/2017] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Coronary bioresorbable scaffolds (BRS) were developed to overcome the limitations of standard metallic stents, especially to address late events after percutaneous coronary interventions. The aim of this meta-analysis was to evaluate the efficacy and safety of BRS, compared with Everolimus-eluting stents (EES), using the data available from randomized trials, with a focus on long-term outcomes. METHODS Published randomized trials comparing BRS to EES for the treatment of coronary artery disease were searched for within PubMed, Cochrane Library and Scopus electronic databases up to April 4th 2017. The summary measure used was odds ratio (OR) with 95% confidence intervals. RESULTS A total of 5 studies were eligible, including 5219 patients. At 2 years, BRS was associated with higher rates of target lesion failure (9.4% vs 7.2%; OR = 1.33; 95% CI 1.07 to 1.63; p = 0.008) and device thrombosis (2.3% vs 0.7%; OR = 3.22; 95% CI 1.86 to 5.57; p < 0.0001) compared with EES. The incidence of both early (within 30 days after implantation, 1.1% vs 0.5%, OR 1.97, 95% CI 1.02 to 3.81; p = 0.05) and very-late device thrombosis (>1 year, 0.6% vs 0.1%, OR 4.03, 95% CI 1.37 to 11.82; p = 0.01) was higher with BRS compared with EES. CONCLUSIONS BRS may be associated with worse two-years clinical outcomes compared with EES in patients with coronary artery disease.
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Affiliation(s)
- Alberto Polimeni
- Zentrum für Kardiologie, University Hospital Mainz, Mainz, Germany.,German Center for Cardiac and Vascular Research (DZHK), Standort Rhein-Main, Mainz, Germany.,Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Remzi Anadol
- Zentrum für Kardiologie, University Hospital Mainz, Mainz, Germany.,German Center for Cardiac and Vascular Research (DZHK), Standort Rhein-Main, Mainz, Germany
| | - Thomas Münzel
- Zentrum für Kardiologie, University Hospital Mainz, Mainz, Germany.,German Center for Cardiac and Vascular Research (DZHK), Standort Rhein-Main, Mainz, Germany
| | - Ciro Indolfi
- Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, 88100, Catanzaro, Italy.,URT-CNR, Department of Medicine, Consiglio Nazionale delle Ricerche of IFC, Viale Europa S/N, 88100, Catanzaro, Italy
| | - Salvatore De Rosa
- Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, 88100, Catanzaro, Italy
| | - Tommaso Gori
- Zentrum für Kardiologie, University Hospital Mainz, Mainz, Germany. .,German Center for Cardiac and Vascular Research (DZHK), Standort Rhein-Main, Mainz, Germany.
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8
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Kang J, Park KW, Kim HS. How far have we come with bioresorbable vascular scaffolds, and where should we go? Cardiovasc Diagn Ther 2017; 7:S86-S90. [PMID: 28748155 PMCID: PMC5509923 DOI: 10.21037/cdt.2017.01.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 11/29/2016] [Indexed: 08/30/2023]
Affiliation(s)
- Jeehoon Kang
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Kyung Woo Park
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
| | - Hyo Soo Kim
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, Korea
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Felix C, Vlachojannis G, IJsselmuiden A, Fam J, Smits P, Lansink W, Diletti R, Zijlstra F, Regar E, Boersma E, Onuma Y, van Geuns R. Potentially increased incidence of scaffold thrombosis in patients treated with Absorb BVS who terminated DAPT before 18 months. EUROINTERVENTION 2017; 13:e177-e184. [DOI: 10.4244/eij-d-17-00119] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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10
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Very Late Scaffold Thrombosis of Bioresorbable Vascular Scaffold. JACC Cardiovasc Interv 2017; 10:27-37. [DOI: 10.1016/j.jcin.2016.10.027] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 10/20/2016] [Indexed: 11/21/2022]
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