Hansen KN, Maehara A, Trøan J, Noori M, Hougaard M, Ellert J, Veien KT, Junker A, Hansen HS, Lassen JF, Jensen LO. Effect of optimal lesion preparation prior to implantation of a magnesium-based bioresorbable scaffold: 12-month results of the OPTIMIS study.
CARDIOVASCULAR REVASCULARIZATION MEDICINE 2025:S1553-8389(25)00071-5. [PMID:
40074646 DOI:
10.1016/j.carrev.2025.03.003]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2025] [Revised: 03/03/2025] [Accepted: 03/04/2025] [Indexed: 03/14/2025]
Abstract
BACKGROUND
Lumen reduction after bioresorbable scaffold implantation has been reported. This study aimed to assess the influence of pre-dilatation with a scoring balloon versus a standard non-compliant balloon prior to implanting a magnesium-based Magmaris bioresorbable scaffold (MgBRS) on lumen measurements using optical coherence tomography (OCT) and on clinical outcomes after 12 months.
METHOD
In the OPTIMIS-study (Optimal lesion preparation before implantation of a MgBRS in patients with coronary artery stenosis), patients were randomly assigned to pre-dilatation with a scoring balloon or a standard non-compliant balloon before MgBRS implantation. OCT was performed before and after scaffold implantation, and at 6- and 12-month follow-up. Clinical 12-month follow-up was performed for all 82 enrolled patients.
RESULTS
Serial pre- and post-procedural, 6- and 12-month OCT were available in 33 lesions (scoring: n = 16 vs. standard: n = 17). Minimal lumen area (MLA) (scoring 4.6 ± 0.5 mm2 vs. standard 3.6 ± 0.5 mm2, p = 0.16) did not differ significantly at 12 months. In both the scoring and standard non-compliant balloon group, MLA changed significantly over time (post-procedure - 6-month - 12-month) (scoring balloon: 7.2 ± 1.8 mm2-5.1 ± 1.7 mm2-5.0 ± 1.9 mm2, p < 0.01, and standard non-compliant balloon: 6.2 ± 1.1 mm2-5.2 ± 1.5 mm2-5.3 ± 2.0 mm2, p < 0.01). No target lesion revascularizations (TLR) occurred in the scoring balloon group, compared to 7 TLR in the standard non-compliant balloon group within 12 months.
CONCLUSION
In lesions treated with MgBRS, MLA did not differ significantly after 12 months among lesions pre-dilated with a scoring balloon compared to a standard non-compliant balloon. However, only lesions pre-dilated with a scoring balloon were free from TLR.
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