Evaluation of bioresorbable vascular scaffolds in acute coronary syndrome: A two-center, one-year follow-up analysis

Cardiol J. 2018;25(4):479-486. doi: 10.5603/CJ.a2017.0131. Epub 2017 Nov 23.

Abstract

Background: Bioresorbable vascular scaffolds (BVS) have emerged as a new treatment option in cardiovascular medicine. Nonetheless, there is still limited data on the use of these novel devices in patients with acute coronary syndromes (ACS). The purpose of this study was to evaluate the feasibility and efficacy of BVS implantation in patients with ACS.

Methods: The present report is a prospective, two-center registry that involved 165 consecutive patients hospitalized with the diagnosis of ACS and treated with the Absorb BVS (Abbot Vascular, Santa Clara, USA). During 1-year, all patients were monitored for the following endpoints: death, myocardial infarction (MI), scaffold thrombosis (ST), target lesion revascularization (TLR), target vessel revascularization (TVR) and target vessel failure (TVF), defined as cardiac death, target vessel MI, and TVR.

Results: A total of 165 patients underwent 179 BVS implantations. 94 patients were diagnosed with unstable angina (UA; 57.6%), 45 with non-ST-segment elevation myocardial infarction (NSTEMI; 27.3%) and 26 with ST-segment elevation myocardial infarction (STEMI; 15.7%). Procedural success was achieved in all patients with thrombolysis in myocardial infarction flow 3. During a follow-up of 14.1 ± 8.5 months (median 12.4 months, IQR 8.7 [8.4 to 12.1] months) death occurred in 4 (2.4%) patients, including 2 (1.3%) cardiac deaths. There was only 1 case of subacute ST (0.66%), without late ST. The incidence of MI, TLR, TVR and TVF were: 2.65%, 2.65%, 7.95%, 9.3%, respectively.

Conclusions: The present results suggest that BVS implantation in ACS patients is feasible and safe in highly experienced centers. One-year clinical results are encouraging with a low rate of stent thrombosis.

Keywords: NSTEMI; STEMI; acute coronary syndrome; acute myocardial infarction; angiography; bioresorbable devices/polymers; coronary.

Publication types

  • Multicenter Study

MeSH terms

  • Absorbable Implants*
  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / surgery*
  • Coronary Angiography
  • Coronary Vessels / diagnostic imaging
  • Coronary Vessels / surgery*
  • Electrocardiography
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / methods*
  • Prospective Studies
  • Prosthesis Design
  • Time Factors
  • Tissue Scaffolds*