Author + information
- Received January 25, 2011
- Revision received March 29, 2011
- Accepted April 11, 2011
- Published online July 1, 2011.
- Josep Gomez-Lara, MD⁎,
- Salvatore Brugaletta, MD⁎,
- Vasim Farooq, MBChB⁎,
- Robert Jan van Geuns, MD, PhD⁎,
- Bernard De Bruyne, MD, PhD†,
- Stephan Windecker, MD‡,
- Dougal McClean, MD§,
- Leif Thuesen, MD∥,
- Dariusz Dudek, MD¶,
- Jacques Koolen, MD, PhD#,
- Robert Whitbourn, MD⁎⁎,
- Pieter C. Smits, MD, PhD††,
- Bernard Chevalier, MD‡‡,
- Marie-Angèle Morel, BSc§§,
- Cécile Dorange, MSc∥∥,
- Susan Veldhof, RN∥∥,
- Richard Rapoza, PhD¶¶,
- Hector M. Garcia-Garcia, MD, PhD⁎,§§,
- John A. Ormiston, MBChB, PhD## and
- Patrick W. Serruys, MD, PhD⁎,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. Patrick W. Serruys, Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, ‘s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands
Objectives The aim of this study was to compare the angiographic changes in coronary geometry of the bioresorbable vascular scaffolds (BVS) and metallic platform stent (MPS) between baseline and follow-up.
Background Coronary geometry changes after stenting might result in wall shear stress changes and adverse events. The BVS have better conformability, compared with MPS, but still modify artery geometry. It is uncertain whether the BVS resorption can restore the coronary anatomical configuration at midterm follow-up.
Methods All patients of the ABSORB (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System [BVS EECSS] in the Treatment of Patients With de Novo Native Coronary Artery Lesions) and SPIRIT (A Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System in the Treatment of Patients With de Novo Native Coronary Artery Lesions) trials treated with a single 3.0 × 18 mm device and imaged at baseline and 6- to 12-month follow-up were eligible. Coronary geometry changes were assessed with quantitative angiography as changes in curvature and angulation. Curvature and angulation changes between systole and diastole were investigated to assess hinging movements of the coronary artery.
Results One hundred sixty-one patients (86 BVS, and 75 MPS) were included. Baseline angiographic characteristics were similar. From post-implantation to follow-up, curvature increased 8.4% (p < 0.01) with BVS and decreased 1.9% (p = 0.54) with MPS; p = 0.01. Angulation increased 11.3% with BVS (p < 0.01) and 3.8% with MPS (p = 0.01); p < 0.01. From pre-implantation to follow-up, BVS decreased 3.4% the artery curvature (p = 0.05) and 3.9% the artery angulation (p = 0.16), whereas MPS presented with 26.1% decrease in curvature (p < 0.01) and 26.9% decrease in angulation (p < 0.01), being larger with MPS (p < 0.01, both). Hinging movements in curvature from pre-implantation to follow-up decreased 19.7% with BVS and 39.0% with MPS (p = 0.27) and decreased 3.9% with BVS and 26.9% with MPS in angulation (p < 0.01).
Conclusions At midterm follow-up, the BVS tended to restore the coronary configuration and the systo-diastolic movements to those seen before implantation. The coronary geometry remained similar to that seen at after implantation with MPS. (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System [BVS EECSS] in the Treatment of Patients With de Novo Native Coronary Artery Lesions; NCT00856856)
The ABSORB Cohort B and the SPIRIT I and II trials have been supported by Abbott Vascular. Dr. Windecker has received research grants from Abbott, Cordis, Medtronic, Biosensors, and Boston Scientific. Dr. Dudek has received research grants or served as a consultant/advisory board member for Abbott, Adamed, AstraZeneca, Biotronik, Balton, Bayer, BBraun, BioMatrix, Boston Scientific, Boehringer Ingelheim, Bristol-Myers Squibb, Cordis, Cook, Eli Lilly, EuroCor, GlaxoSmithKline, Invatec, Medtronic, The Medicines Company, Merck Sharp & Dohme, Nycomed, Orbus-Neich, Pfizer, Possis, Promed, Sanofi-Aventis, Siemens, Solvay, Terumo, and Tyco. Dr. Smits has received speaker and travel fees from Abbott Vascular. Dr. Chevalier is a consultant for Abbott Vascular. Cécile Dorange, Susan Veldhof, and Dr. Rapoza are employees of Abbott Vascular. Dr. Ormiston is on the advisory boards for Abbott and Boston Scientific; and has received minor honoraria from Abbott and Boston Scientific. All other authors have reported that they have no relationships to disclose. Eric Bates, MD, served as Guest Editor for this paper.
- Received January 25, 2011.
- Revision received March 29, 2011.
- Accepted April 11, 2011.
- American College of Cardiology Foundation