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Comparison of acute expansion of bioresorbable vascular scaffolds versus metallic drug‐eluting stents in different degrees of calcification: An optical coherence tomography study
Author(s) -
Ming Fam Jiang,
van Der Sijde Johannes N,
Karanasos Antonios,
Felix Cordula,
Diletti Roberto,
van Mieghem Nicolas,
de Jaegere Peter,
Zijlstra Felix,
Jan van Geuns Robert,
Regar Evelyn
Publication year - 2017
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.26676
Subject(s) - medicine , calcification , optical coherence tomography , lesion , apposition , radiology , nuclear medicine , surgery
Objectives The acute expansion of bioresorbable vascular scaffolds (BRS) and drug‐eluting stents (DES) in lesions with different extent of calcification was compared by Optical Coherence Tomography (OCT). Background The acute mechanical performance of polymeric BRS in calcified lesions is poorly understood. Methods Acute device performance in lesions treated with either BRS( N = 50) or DES ( N = 50) was compared using Optical Coherence Tomography (OCT). According to angiographic degree of calcification the lesions were divided in three groups: no/mild, moderate and heavy calcification. Device performance was assessed with the following parameters by OCT: mean scaffold area, eccentricity index (EI), symmetry index (SI) and percentage incomplete strut apposition (ISA). Results One hundred lesions from 85 patients (BRS/DES; 37/48) were analyzed. Scaffold area and SI were similar between BRS and DES groups in the three calcification subgroups. Compared to DES, EI in BRS was marginally lower in the no/mild calcification group (0.86 ± 0.03 versus 0.88 ± 0.03, p = 0.018) but was similar in the moderate and heavy calcification groups. Compared to DES, percentage ISA struts in BRS was similar in the no/mild calcification group and was significantly lower in the moderate and heavy calcification groups (2.96 ± 2.36 versus 6.78 ± 4.61%, p = 0.002 and 1.82 ± 2.40 versus 8.89 ± 8.25%, p = 0.025 respectively). Conclusions With adequate lesion preparation, implantation of BRS in a population reflective of clinical practice, resulted in a similar luminal gain compared to DES as measured by OCT, regardless of the degree of angiographic calcification, while acute malapposition is lower with BRS in moderately and heavily calcified lesions. The clinical significance of our findings warrants further evaluation in future studies. © 2016 Wiley Periodicals, Inc.