• Clinical outcomes of bioresorbable vascular scaffold to treat all-comer patients. Are patients with acute coronary syndrome better candidates for bioresorbable vascular scaffold?

    Abstract

    Background

    Scaffold thromboses (ST) and adverse events and have been associated with bioresorbable vascular scaffolds (BVS) at long-term, but their mechanism remains unclear. We sought to evaluate patient and lesion characteristics associated with mid- to long-term outcomes in patients treated with BVS.

    Methods

    This is an observational single-center, single-arm, retrospective study evaluating the performance of BVS in an all-comer population, including complex lesions (chronic total occlusions, long lesions), small vessels, and acute coronary syndromes (ACS).

    Results

    From May 2013 to June 2015, we included 482 patients (580 lesions) that were treated with BVS implantation including 71.2% treated for ACS in the present analysis. Mean follow-up period was 816.2 ± 242.6 days. The primary endpoint was device oriented cardiac events (DOCE), defined as a composite of target-lesion revascularization (TLR), ST, target vessel myocardial infarction (TVMI) and cardiac death. Using Kaplan-Meier methods, the DOCE and ST rates at 36 months were 9.4% and 2.3%, respectively. No ST occurred between 2 and 3 years and ST occurred after 3 years, in one patient. Using multivariate analysis, ACS was the only significant predictor of lower rates of DOCE ( = 0.04, HR: 0.47, 95% CI: 0.23–0.96).

    Conclusions

    In this large all-comers real-world cohort, lesions treated with BVS had non-negligible rates of DOCE and ST, in line with previous published randomized trials. The occurrence of very late event was very low after 24 months. ACS patients had lower rates of DOCE.

    Highlights

    • Scaffold thromboses and adverse events and have been associated with bioresorbable vascular scaffolds at long-term, but their mechanism remains unclear.
    • In this large all-comers cohort, lesions treated with bioresorbable vascular scaffold had non negligible rates of events.
    • The occurrence of very late event was very low after 24 months.
    • Acute coronary syndrome patients had low rates of events and could benefit from bioresorbable vascular scaffolds implantation.

    Author bio

    Cardiovascular Revascularization Medicine, Copyright © 2018

     

    Source:

    Read the full article on Science Direct: Clinical outcomes of bioresorbable vascular scaffold to treat all-comer patients. Are patients with acute coronary syndrome better candidates for bioresorbable vascular scaffold?

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