Turk Kardiyol Dern Ars. 2021; 49(1): 40-50 | DOI: 10.5543/tkda.2020.99249
Long-term outcomes of Absorb bioresorbable vascular scaffold using predilation, sizing, and postdilation protocol in a real-world patient population
, Beytullah Çakal
, Oğuz Karaca
, Bilal Boztosun
Department of Cardiology, İstanbul Medipol University Faculty of Medicine, İstanbul, Turkey
OBJECTIVE Bioresorbable vascular scaffolds (BVSs) have been a disappointment in the evolution of drug-eluting stents used in percutaneous coronary intervention because an excessive number of thrombotic complications have been reported. The aim of this study was to evaluate long-term clinical outcomes of the Absorb BVS in patients treated using a predilation, proper sizing, and post-dilation implantation technique.
METHODS The records of 110 patients who had a total of 150 Absorb BVSs implanted were retrospectively analyzed. The rate of major adverse cardiovascular events (MACEs), defined as the composite of cardiac death, target vessel myocardial infarction (MI), and target-lesion revascularization were studied using quantitative coronary angiography.
RESULTS Of the study population, 80% were male and the mean age was 60±11.3 years. The most common diagnosis was stable angina (84%). The median length of follow-up was 53 months (range: 4659 months). The rate of predilation and postdilation was 100%, and 95%, respectively. The 4-year rate of MACEs was 20%: cardiac death in 3 patients (2.7%), target vessel MI in 9 (8.2%), and target lesion revascularization in 20 (18.2%). Definite device thrombosis occurred in 6 of 110 patients (5.5%). One case of very late scaffold thrombosis was observed at 47 months. A small BVS diameter (2.5 mm) was found to be the most powerful independent predictor of a MACE (p=0.05).
CONCLUSION The Absorb BVS was associated with an increased risk of adverse events, including late and very late device thrombosis, despite the use of a good implementation protocol.
Absorb bioresorbable vascular scaffold, coronary artery disease; percutaneous coronary intervention.
How to cite this article
Sinem Çakal, Beytullah Çakal, Oğuz Karaca, Bilal Boztosun. Long-term outcomes of Absorb bioresorbable vascular scaffold using predilation, sizing, and postdilation protocol in a real-world patient population. Turk Kardiyol Dern Ars. 2021; 49(1): 40-50
Corresponding Author: Sinem Çakal, Türkiye