Impact of the Everolimus-eluting Bioresorbable Scaffold in Coronary Atherosclerosis.

Abstract

INTRODUCTION AND OBJECTIVES:

The Absorb bioresorbable vascular scaffold has been shown to decrease total plaque areas in the treated segment. However, it is unknown whether plaque size is modified in scaffolded segments only or whether the modification extends to other coronary segments.

METHODS:

Absorb Cohort A is a single-arm, prospective study, with safety and imaging endpoints, in which 30 patients underwent percutaneous coronary intervention with the first generation Absorb bioresorbable vascular scaffold. Noninvasive multislice computed tomography imaging was performed in 18 patients at 18 months and 5 years of follow-up. The present study was an intrapatient comparison of matched segments (normalized by the segment length) of the scaffolded region with nonintervened segments for lumen volume, vessel volume, plaque volume, plaque burden, and percent change in plaque atheroma volume.

RESULTS:

All 18 scaffolded segments could be analyzed. In the nonintervened segments, 1 of 72 segments had a motion artifact and was excluded. Serial comparison showed that the scaffolded segments showed no significant change in the mean plaque burden, total atheroma volume, total lumen volume, or vessel volume between 18 months and 5 years. Conversely, the untreated segments showed a significant increase in plaque burden (2.7 ± 6.5%; P < .01) and normalized plaque volumes (8.0 ± 22.8mm(3); P < .01). This resulted in a significant difference in plaque burden between scaffolded and nonintervened segments (P = .03).

CONCLUSIONS:

In this small series, the Absorb bioresorbable vascular scaffold showed the potential to provide an additional benefit to pharmacological therapy in locally reducing progression of percent plaque burden. These findings need to be confirmed in larger studies.

• Authors: Carlos M Campos, Hector M Garcia-Garcia, Takashi Muramatsu, Pedro de Araujo Gonçalves, Yoshinobu Onuma, Dariusz Dudek, Leif Thuesen, Mark W I Webster, Pieter Kitslaar, Susan Veldhof, Johan H C Reiber, Koen Nieman, John A Ormiston, Patrick W Serruys
• Journal: Revista espanola de cardiologia (English ed.) (Rev Esp Cardiol (Engl Ed)) Vol. 69 Issue 2 Pg. 109-16 (Feb 2016) ISSN: 1885-5857 [Electronic] Spain
• PMID: 26739828 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Chemical References

• Immunosuppressive Agents
• Everolimus

Topics

• Absorbable Implants
• Computed Tomography Angiography
• Coronary Artery Disease (diagnostic imaging, drug therapy)
• Coronary Stenosis (diagnostic imaging, drug therapy)
• Drug-Eluting Stents
• Everolimus (administration & dosage)
• Female
• Humans
• Immunosuppressive Agents (administration & dosage)
• Male
• Middle Aged
• Multidetector Computed Tomography
• Prospective Studies
• Tissue Scaffolds
• Treatment Outcome