Author + information
- Enrico Fabris1,
- Gianluca Caiazzo1,
- Ismail Dogu Kilic1,
- Roberta Serdoz1,
- Gioel Gabrio Secco1,
- Nicolas Foin2 and
- Carlo Di Mario1
Because of concerns about the risk of bioresorbable drug-eluting scaffolds (BVS) damage, post-dilation was not recommended and applied in the existing randomized studies and most registries. Recent real world data suggest incomplete BVS expansion cause higher rates of thrombosis. In vivo confirmation of the safety of high pressure post-dilation (HPPD) is of paramount importance. Optical coherence tomography (OCT) was used to investigate integrity and expansion of BVS after HPPD.
Data from final OCT examination of consecutive implanted BVS, post dilated with non-compliant (NC) balloons at pressure ≥24 atm were analyzed. The following stent performance indices were assessed with OCT: mean and minimal lumen and scaffold area, residual area stenosis (RAS), incomplete strut apposition (ISA), tissue prolapse, eccentricity index (EI), symmetry index (SI), strut fractures and edge dissections.
Twenty-two BVS post dilated at high pressure were analyzed. The average maximal post-dilation balloon inflation (maxPD) was 28±3 atm. High pressure OPN NC Balloon (SIS Medical AG, Winterthur Switzerland) was used in 41% of post-dilations with a maximal PD of 30±4.7 atm. Final mean and minimal lumen area were 6.8±1.4 and 5.5±1.4 mm2, respectively. OCT showed low percentage of RAS (16±9.6%), and low percentage of ISA (1.8±2.4%). Mean EI was 0.86±0.02 and SI 0.35±0.14. OCT analysis showed one edge dissection and no scaffold fractures.
BVS deployment optimization using HPPD does not cause BVS disruption and is associated with a good BVS expansion, low strut malapposition and edge dissection.