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Direct bioresorbable vascular scaffold implantation: Feasibility and midterm results
Author(s) -
Suárez de Lezo Javier,
Martín Pedro,
Mazuelos Francisco,
Nóvoa José,
Ojeda Soledad,
Pan Manuel,
Segura José,
Hernández Enrique,
Romero Miguel,
Melián Francisco,
Medina Alfonso,
Suárez de Lezo José
Publication year - 2016
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.26133
Subject(s) - medicine , balloon , lesion , intravascular ultrasound , bioresorbable scaffold , radiology , myocardial infarction , surgery , angioplasty , thrombosis , percutaneous coronary intervention , cardiology
Objectives To analyze the feasibility and safety of direct bioresorbable vascular scaffold (BVS) implantation without previous balloon dilation. Background Lesion preparation through predilation is recommended before BVS implantation. There is no information on the routine use of direct BVS implantation. Methods and Results One hundred fifty‐three patients with a total of 200 coronary lesions, were treated with BVS. A baseline intravascular ultrasound study (IVUS) was performed in 171 lesions (86%), and after BVS implantation, the quality of scaffolding was assessed with an additional IVUS (83, 41%) or optical coherence tomography (77, 38%). Elective predilation was conducted in 50 lesions. In 150 lesions, direct BVS implantation was attempted. In 129 lesions (86%), the BVS was implanted successfully, and in the remaining 21 (14%), direct implantation failed. In these cases, the scaffolds were retrieved and successfully implanted after balloon angioplasty. Longer and C‐type lesions, and a larger plaque burden, were associated with failure to directly cross the lesion. Balloon postdilation was needed in 34% of the lesions. Ten patients (6.6%) had a periprocedural myocardial infarction. One patient (0.6%) died 60 days after BVS implantation due to thrombosis of the scaffold. At follow‐up, target lesion revascularisation was needed in eight patients (5%). After 12 ± 3 months, the remaining patients were symptom‐free. Conclusions Direct BVS implantation is safe and feasible in most soft coronary plaques. © 2015 Wiley Periodicals, Inc.