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A Polylactide Bioresorbable Scaffold Eluting Everolimus for Treatment of Coronary Stenosis: 5-Year Follow-Up.

Authors :
Serruys, Patrick W.
Ormiston, John
van Geuns, Robert-Jan
de Bruyne, Bernard
Dudek, Dariusz
Christiansen, Evald
Chevalier, Bernard
Smits, Pieter
McClean, Dougal
Koolen, Jacques
Windecker, Stephan
Whitbourn, Robert
Meredith, Ian
Wasungu, Luc
Ediebah, Divine
Veldhof, Susan
Onuma, Yoshinobu
Source :
Journal of the American College of Cardiology (JACC). Feb2016, Vol. 67 Issue 7, p766-776. 11p.
Publication Year :
2016

Abstract

<bold>Background: </bold>Long-term benefits of coronary stenosis treatment with an everolimus-eluting bioresorbable scaffold are unknown.<bold>Objectives: </bold>This study sought to evaluate clinical and imaging outcomes 5 years after bioresorbable scaffold implantation.<bold>Methods: </bold>In the ABSORB multicenter, single-arm trial, 45 (B1) and 56 patients (B2) underwent coronary angiography, intravascular ultrasound (IVUS), and optical coherence tomography (OCT) at different times. At 5 years, 53 patients without target lesion revascularization underwent final imaging.<bold>Results: </bold>Between 6 months/1 year and 5 years, angiographic luminal late loss remained unchanged (B1: 0.14 ± 19 mm vs. 0.13 ± 0.33 mm; p = 0.7953; B2: 0.23 ± 0.28 mm vs. 0.18 ± 0.32 mm; p = 0.5685). When patients with a target lesion revascularization were included, luminal late loss was 0.15 ± 0.20 mm versus 0.15 ± 0.24 mm (p = 0.8275) for B1 and 0.30 ± 0.37 mm versus 0.32 ± 0.48 mm (p = 0.8204) for B2. At 5 years, in-scaffold and -segment binary restenosis was 7.8% (5 of 64) and 12.5% (8 of 64). On IVUS, the minimum lumen area of B1 decreased from 5.23 ± 0.97 mm(2) at 6 months to 4.89 ± 1.81 mm(2) at 5 years (p = 0.04), but remained unchanged in B2 (4.95 ± 0.91 mm(2) at 1 year to 4.84 ± 1.28 mm(2) at 5 years; p = 0.5). At 5 years, struts were no longer discernable by OCT and IVUS. On OCT, the minimum lumen area in B1 decreased from 4.51 ± 1.28 mm(2) at 6 months to 3.65 ± 1.39 mm(2) at 5 years (p = 0.01), but remained unchanged in B2, 4.35 ± 1.09 mm(2) at 1 year and 4.12 ± 1.38 mm(2) at 5 years (p = 0.24). Overall, the 5-year major adverse cardiac event rate was 11.0%, without any scaffold thrombosis.<bold>Conclusions: </bold>At 5 years, bioresorbable scaffold implantation in a simple stenotic lesion resulted in stable lumen dimensions and low restenosis and major adverse cardiac event rates. (ABSORB Clinical Investigation, Cohort B [ABSORB B]; NCT00856856). [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
07351097
Volume :
67
Issue :
7
Database :
Academic Search Index
Journal :
Journal of the American College of Cardiology (JACC)
Publication Type :
Academic Journal
Accession number :
112825331
Full Text :
https://doi.org/10.1016/j.jacc.2015.11.060