TY - JOUR
T1 - Restenosis patterns after bioresorbable vascular scaffold implantation
T2 - Angiographic substudy of the GHOST-EU registry
AU - Baquet, Moritz
AU - Nef, Holger
AU - Gori, Tomasso
AU - Latib, Azeem
AU - Capodanno, Davide
AU - Di Mario, Carlo
AU - Sabate, Manel
AU - Colombo, Antonio
AU - Tamburino, Corrado
AU - Mehilli, Julinda
N1 - Funding Information:
H. Nef reports receiving lecture fees from Abbott Vascular and Elixir Medical, as well as research grants from Abbott Vascular; T. Gori reports receiving lecture fees from Abbott Vascular; A. Latib reports receiving consulting/lecture fees from Medtronic; D. Capodanno reports receiving consulting/lecture fees from Abbott Vascular, AstraZeneca, Bayer Sanofi Aventis, Daiichi Sankyo; C. Di Mario reports receiving institutional research grant from Abbott Vascular; C. Tamburino reports receiving institutional research grant from Edwards Lifescience and lecture fees from Abbott Vascular, Edwards Lifesciences and Medtronic; M. Sabate reports receiving lecture fees from Abbott Vascular; J. Mehilli reports receiving lecture fees from Abbott Vascular, Boston Scientific, Biotronik, Edwards Lifescience, Terumo, and institutional research grant from Abbott Vascular and Edwards Lifescience. All other authors have no conflicts of interest to declare.
Publisher Copyright:
© 2017 Wiley Periodicals, Inc.
PY - 2018/8/1
Y1 - 2018/8/1
N2 - Objectives: To evaluate pattern of in-BVS-restenosis after bioresorbable vascular scaffold (BVS) implantation. Background: In-stent restenosis morphology impacts target lesion revascularization (TLR) rates and clinical outcomes. Although several trials report on outcomes after BVS implantation, information about in-BVS restenosis pattern is still lacking. Methods: Between November 2011 and January 2014, in 7 of 10 European centers participating in the GHOST-EU registry, 668 patients underwent BVS implantation. Of them 164 patients (200 lesions) underwent an additional angiogram 3 to 12 months after index PCI. Results: Binary in-BVS restenosis (IBR) (in-segment diameter stenosis ≥50%) was observed in 12.7% (21 of 164) of patients (30 lesions), with a TLR rate of 16.5%. The IBR morphology was classified as focal margin in 50.0%, focal body in 26.7%, multifocal in 10.0%, and diffuse in 13.3% of these cases. Treatment of small vessels (OR 5.49, 95% CI 1.6–18.8, P < 0.01) was identified as independent predictor of IBR. Performing predilatation (OR 0.13, 95% CI 0.02–1.04, P = 0.06), high-pressure postdilatation (OR 3.16, 95% CI 0.90–11.18, P = 0.07) as well as treatment of acute coronary syndrome (OR 0.18, 95% CI 0.03–1.12, P = 0.07) seem to strongly influence this risk. Conclusions: The IBR morphology is mostly focal involving particularly the BVS margins suggesting association with procedural aspects in this early experience with BVS. Treatment of small vessels is the strongest predictor of higher IBR risk.
AB - Objectives: To evaluate pattern of in-BVS-restenosis after bioresorbable vascular scaffold (BVS) implantation. Background: In-stent restenosis morphology impacts target lesion revascularization (TLR) rates and clinical outcomes. Although several trials report on outcomes after BVS implantation, information about in-BVS restenosis pattern is still lacking. Methods: Between November 2011 and January 2014, in 7 of 10 European centers participating in the GHOST-EU registry, 668 patients underwent BVS implantation. Of them 164 patients (200 lesions) underwent an additional angiogram 3 to 12 months after index PCI. Results: Binary in-BVS restenosis (IBR) (in-segment diameter stenosis ≥50%) was observed in 12.7% (21 of 164) of patients (30 lesions), with a TLR rate of 16.5%. The IBR morphology was classified as focal margin in 50.0%, focal body in 26.7%, multifocal in 10.0%, and diffuse in 13.3% of these cases. Treatment of small vessels (OR 5.49, 95% CI 1.6–18.8, P < 0.01) was identified as independent predictor of IBR. Performing predilatation (OR 0.13, 95% CI 0.02–1.04, P = 0.06), high-pressure postdilatation (OR 3.16, 95% CI 0.90–11.18, P = 0.07) as well as treatment of acute coronary syndrome (OR 0.18, 95% CI 0.03–1.12, P = 0.07) seem to strongly influence this risk. Conclusions: The IBR morphology is mostly focal involving particularly the BVS margins suggesting association with procedural aspects in this early experience with BVS. Treatment of small vessels is the strongest predictor of higher IBR risk.
KW - bioresorbable vascular scaffold
KW - patterns of restenosis
KW - quantitative coronary angiography
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U2 - 10.1002/ccd.27350
DO - 10.1002/ccd.27350
M3 - Article
C2 - 29171715
AN - SCOPUS:85035009296
SN - 1522-1946
VL - 92
SP - 276
EP - 282
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 2
ER -