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Velagaleti RS, Harrell C, Michalski J, Lefèvre T, Windecker S, Slagboom T, Saito S, Koolen J, Waksman R, Kandzari DE. Impact of preprocedural left ventricular systolic function on the safety and durability of percutaneous coronary intervention. Catheter Cardiovasc Interv 2024; 103:523-531. [PMID: 38440914 DOI: 10.1002/ccd.30995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/07/2024] [Accepted: 02/16/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) is considered less safe in patients with reduced ejection fraction (EF), an impression based on older data. Whether the safety and durability of contemporary PCI are different in patients with reduced EF compared with normal EF patients is unknown. METHODS Patients from the BIOFLOW II, IV and V clinical trials were grouped as normal EF (≥50%) and reduced EF (30%-50%). Using multivariable logistic regression and cox proportional hazards regression, we determined relations of EF category with procedural safety (a composite of cardiac death, myocardial infarction, stroke and urgent coronary artery bypass grafting within 30 days of PCI) and target lesion failure (TLF; comprising cardiac death, target vessel myocardial infarction, target vessel revascularization within 1 year of PCI) respectively. In sensitivity analyses, we regrouped patients into EF < 45% and ≥55% and repeated the aforementioned analyses. RESULTS In 1685 patients with normal EF (mean age 65 years; 27% women; mean EF 61%) and 259 with low EF (mean age 64 years; 17% women; mean EF 41%), 101 safety and 148 TLF events occurred. Compared with patients in the normal EF group, those with reduced EF had neither a statistically significant higher proportion of safety events, nor a higher multivariable-adjusted risk for such events. Similarly, patients with reduced EF and normal EF did not differ in terms of TLF event proportions or multivariable-adjusted risk for TLF. The results were similar in sensitivity analyses with EF groups redefined to create a 10% between-group EF separation. CONCLUSION PCI safety and durability outcomes are similar in patients with mild-moderately reduced EF and normal EF.
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Affiliation(s)
| | | | | | - Thierry Lefèvre
- Department of Interventional Cardiology, Hopital Jacques Cartier, Massy, France
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Ton Slagboom
- Cardiology Unit, OLVG, Amsterdam, The Netherlands
| | - Shigeru Saito
- Okinawa Tokushukai Shonan Kamakura General Hospital, Kanagawa, Japan
| | | | - Ron Waksman
- Division of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, Washington, USA
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Abizaid A, Costa R, Kedev S, Kedhi E, Talwar S, Erglis A, Hlinomaz O, Masotti M, Fath-Ordoubadi F, Milewski K, Lemos P, Botelho R, Ijsselmuiden A, Koolen J, Kala P, Janssens L, Chandra U. A Randomized Controlled Trial Comparing BioMime Sirolimus-Eluting Stent With Everolimus-Eluting Stent: Two-Year Outcomes of the meriT-V Trial. Cardiol Res 2023; 14:291-301. [PMID: 37559713 PMCID: PMC10409544 DOI: 10.14740/cr1498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 05/25/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Drug-eluting stents (DESs) based on biodegradable polymers (BPs) have been introduced to reduce the risk for late and very late stent thrombosis (ST), which were frequently observed with earlier generations of DES designs based on durable polymers (DPs); however, randomized controlled trials on these DES designs are scarce. The meriT-V trial is a randomized, active-controlled, non-inferiority trial with a prospective, multicenter design that evaluated the 2-year efficacy of a novel third-generation, ultra-thin strut, BP-based BioMime sirolimus-eluting stent (SES) versus the DP-based XIENCE everolimus-eluting stent (EES) for the treatment of de novo lesions. METHODS The meriT-V is a randomized trial that enrolled 256 patients at 15 centers across Europe and Brazil. Here, we report the outcomes of the extended follow-up period of 2 years. The randomization of enrolled patients was in a 2:1 ratio; the enrolled patients received either the BioMime SES (n = 170) or the XIENCE EES (n = 86). The three-point major adverse cardiac event (MACE), defined as a composite of cardiac death, myocardial infarction (MI), or ischemia-driven target vessel revascularization (ID-TVR), was considered as the composite safety and efficacy endpoint. Ischemia-driven target lesion revascularization (ID-TLR) was evaluated as well as the frequency of definite/probable ST, based on the first Academic Research Consortium definitions. RESULTS The trial had a 2-year follow-up completion rate of 98.44% (n = 252/256 patients), and the clinical outcomes assessment showed a nonsignificant difference in the cumulative rate of three-point MACE between both arms (BioMime vs. XIENCE: 7.74% vs. 9.52%, P = 0.62). Even the MI incidences in the BioMime arm were insignificantly lower than those of the XIENCE arm (1.79% vs. 5.95%, P = 0.17). Late ST was observed in 1.19% cases of the XIENCE arm, while there were no such cases in the BioMime arm (P = 0.16). CONCLUSIONS The objective comparisons between the novel BP-based BioMime SES and the well-established DP-based XIENCE EES in this randomized controlled trial show acceptable outcomes of both the devices in the cardiac deaths, MI, ID-TVR, and ST. Moreover, since there were no incidences of cardiac death in the entire study sample over the course of 2 years, we contend that the findings of the study are highly significant for both these DES designs. In this preliminary comparative trial, the device safety of BioMime SES can be affirmed to be acceptable, considering the lower three-point MACE rate and absence of late ST in the BioMime arm over the 2-year period.
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Affiliation(s)
| | - Ricardo Costa
- Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil
| | - Sasko Kedev
- University Clinic of Cardiology, Skopje, FYR of Macedonia
| | | | | | | | - Ota Hlinomaz
- ICRC, St. Anne’s University Hospital, Brno, the Czech Republic
| | - Monica Masotti
- University Hospital Clinic de Barcelona, Barcelona, Spain
| | | | | | - Pedro Lemos
- Heart Institute-InCor, University of Sao Paulo, Sao Paulo, Brazil
| | | | | | | | - Petr Kala
- University Hospital, Brno, Czech Republic
| | - Luc Janssens
- Imelda Ziekenhuis Cardiology, Bonheiden, Belgium
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3
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Koolen J, Breteler J. It Was the First Idea, More Than 25 Years Ago…. Cardiovasc Revasc Med 2022; 43:36-37. [PMID: 35909033 DOI: 10.1016/j.carrev.2022.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 07/22/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Jacques Koolen
- Catharina Hospital Eindhoven, Michelangelolaan 2, 5623EJ Eindhoven, the Netherlands.
| | - Judith Breteler
- Catharina Hospital Eindhoven, Michelangelolaan 2, 5623EJ Eindhoven, the Netherlands
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4
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Toelg R, Slagboom T, Waltenberger J, Lefèvre T, Saito S, Kandzari DE, Koolen J, Richardt G. Individual patient data analysis of the BIOFLOW study program comparing safety and efficacy of a bioresorbable polymer sirolimus eluting stent to a durable polymer everolimus eluting stent. Catheter Cardiovasc Interv 2021; 98:848-856. [PMID: 32890442 PMCID: PMC9292184 DOI: 10.1002/ccd.29254] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/11/2020] [Accepted: 08/08/2020] [Indexed: 11/07/2022]
Abstract
OBJECTIVES This analysis of pooled individual patient data (IPD) aimed to evaluate the safety and efficacy of a bioresorbable polymer sirolimus eluting stent system (BP-SES; Orsiro) compared to a durable polymer everolimus eluting stent system (DP-EES; Xience) in the pooled population as well as in subgroups. METHODS IPD with up to 12 months follow-up of the randomized controlled trials BIOFLOW-II (NCT01356888), -IV (NCT01939249), and -V (NCT02389946) as well as the all comers registry BIOFLOW-III (NCT01553526) were pooled. A total of 3,717 subjects (2,923 in BP-SES and 794 in DP-EES) with 5,328 lesions (4,225 lesions in BP-SES and 1,103 in DP-EES) were included in the IPD. The primary endpoint was target lesion failure (TLF) at 12 months follow-up. Subgroups analyzed included diabetes, age (≥65 years), gender, complex lesions (B2/C), small vessels (reference vessel diameter ≤2.75 mm), multivessel treatment, renal disease, and patients with acute coronary syndrome. RESULTS Overall, TLF at 12 months was significantly lower with 5.2%in the BP-SES group versus 7.6% in the DP-EES group (p = .0098). Similarly, target vessel myocardial infarction (TV-MI) was 3.1 versus 5.7% (p = .0005). The rate of stent thrombosis was similar in both groups (0.004%). By regression analysis, an independent stent effect in favor of BP-SES was observed for TLF (p = .0043) and TV-MI (p = .0364) in small vessels. CONCLUSION Results of this IPD analysis suggest that the BP-SES with ultrathin struts is as safe as and more efficacious than DP-EES in the overall cohort and especially in small vessels.
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Affiliation(s)
- Ralph Toelg
- HerzzentrumSegeberger Kliniken GmbHBad SegebergGermany
| | | | | | | | - Shigeru Saito
- Department of CardiologyOkinawa Tokushukai Shonan Kamakura General HospitalKamakuraJapan
| | | | | | - Gert Richardt
- HerzzentrumSegeberger Kliniken GmbHBad SegebergGermany
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5
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Hemetsberger R, Abdelghani M, Toelg R, Mankerious N, Allali A, Garcia-Garcia HM, Windecker S, Lefèvre T, Saito S, Slagboom T, Kandzari D, Koolen J, Waksman R, Richardt G. Impact of Coronary Calcification on Clinical Outcomes After Implantation of Newer-Generation Drug-Eluting Stents. J Am Heart Assoc 2021; 10:e019815. [PMID: 34056911 PMCID: PMC8477856 DOI: 10.1161/jaha.120.019815] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Percutaneous coronary intervention of calcified lesions was associated with worse outcomes in the era of bare‐metal and first‐generation drug‐eluting stents. Data on percutaneous coronary intervention of calcified lesions with newer‐generation drug‐eluting stents are scarce. Therefore, we investigated the impact of lesion calcification on clinical outcomes in patients undergoing percutaneous coronary intervention with a bioresorbable‐polymer sirolimus‐eluting stent or a durable‐polymer everolimus‐eluting stent. Methods and Results Patients (n=2361) from BIOFLOW II, IV, and V trials were categorized into moderate/severe versus none/mild lesion calcification by a core laboratory. End points were target‐lesion failure (TLF) (cardiac death, target‐vessel myocardial infarction, or target‐lesion revascularization) and probable/definite stent thrombosis at 2 years. The agreement in calcification assessment between the operator and the core laboratory was weak (weighted κ, 0.23). Patients with moderate/severe calcification (n=303; 16%) had higher TLF (13.5% versus 8.4%; P=0.003) and stent thrombosis rates (2.1% versus 0.2%; P<0.0001), whereas target‐lesion revascularization was not different between the groups (5.0% versus 3.9%; P=0.302). After adjustment, calcification did not emerge as an independent predictor of TLF (adjusted hazard ratio [aHR], 1.37; 95% CI, 0.89–2.08; P=0.148) but did for target‐vessel myocardial infarction (aHR, 1.66; 95% CI, 1.03–2.68; P=0.037). TLF rates were similar between bioresorbable‐polymer sirolimus‐eluting stent and durable‐polymer everolimus‐eluting stent (12.6% versus 15.4%, P=0.482) in moderate/severe calcification. In none/mild calcification, the bioresorbable‐polymer sirolimus‐eluting stent showed lower TLF (7.5% versus 10.3%, P=0.045). Conclusions With newer‐generation drug‐eluting stents, moderate/severe lesion calcification was not associated with more TLF after adjustment for the higher risk of patients with coronary calcification, whereas the rate of target‐vessel myocardial infarction was higher. The bioresorbable‐polymer sirolimus‐eluting stent and durable‐polymer everolimus‐eluting stent were equally effective and safe in calcified lesions. Registration URL: https://www.clinicaltrials.gov; Unique identifiers: NCT01356888, NCT01939249, NCT02389946.
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Affiliation(s)
| | - Mohammad Abdelghani
- Cardiology Department Al-Azhar University Cairo Egypt.,Cardiology Department Amsterdam University Medical CenterUniversity of Amsterdam the Netherlands
| | - Ralph Toelg
- Heart Center Bad Segeberg Segeberger Kliniken GmbH Bad Segeberg Germany
| | - Nader Mankerious
- Heart Center Bad Segeberg Segeberger Kliniken GmbH Bad Segeberg Germany
| | - Abdelhakim Allali
- Heart Center Bad Segeberg Segeberger Kliniken GmbH Bad Segeberg Germany
| | | | | | | | - Shigeru Saito
- Okinawa Tokushukai Shonan Kamakura General Hospital Kamakura Japan
| | - Ton Slagboom
- Onze Lieve Vrouwe Gasthuis Amsterdam the Netherlands
| | | | | | - Ron Waksman
- Medstar Washington Hospital Center Washington DC
| | - Gert Richardt
- Heart Center Bad Segeberg Segeberger Kliniken GmbH Bad Segeberg Germany
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6
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Pilgrim T, Rothenbühler M, Siontis GC, Kandzari DE, Iglesias JF, Asami M, Lefèvre T, Piccolo R, Koolen J, Saito S, Slagboom T, Muller O, Waksman R, Windecker S. Biodegradable polymer sirolimus-eluting stents vs durable polymer everolimus-eluting stents in patients undergoing percutaneous coronary intervention: A meta-analysis of individual patient data from 5 randomized trials. Am Heart J 2021; 235:140-148. [PMID: 33609498 DOI: 10.1016/j.ahj.2021.02.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 02/06/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Newest generation drug-eluting stents combine biodegradable polymers with ultrathin stent platforms in order to minimize vessel injury and inflammatory response. Evidence from randomized controlled trials suggested that differences in stent design translate into differences in clinical outcome. The aim of the present study was to evaluate the safety and efficacy of ultrathin strut, biodegradable polymer sirolimus eluting stents (BP SES) compared with thin strut, durable polymer everolimus-eluting stents (DP EES) among patients undergoing percutaneous coronary intervention (PCI). METHODS We pooled individual participant data from 5 randomized trials (NCT01356888, NCT01939249, NCT02389946, NCT01443104, NCT02579031) including a total of 5,780 patients, and performed a one-stage meta-analysis using a mixed effects Cox regression model. RESULTS At a median duration of follow-up of 739 days (interquartile range 365-1,806 days), target-lesion failure occurred in 337 (10.3%) and 304 (12.2%) patients treated with BP SES and DP EES (HR 0.86, 95%CI 0.71-1.06, P = .16). There were no significant differences between BP SES and DP EES with regards to cardiac death (111 (3.4%) vs 102 (4.1%); HR 1.05, 95%CI 0.80-1.37, P = .73), target-vessel myocardial infarction (136 (4.1%) vs 126 (5.0%), HR 0.79, 95%CI 0.62-1.01, P = .061), and clinically-driven target-lesion revascularization (163 (5.0%) vs 147 (5.9%); HR 0.94, 95%CI 0.75-1.18, P = .61). The effect was consistent across major subgroups. In a landmark analysis, there was no significant interaction between treatment effect and timing of events. CONCLUSIONS In this patient-level meta-analysis of 5 randomized controlled trials, BP SES were associated with a similar risk of target-lesion failure compared with DP EES among patients undergoing PCI. STUDY REGISTRATION PROSPERO registry (CRD42018109098).
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Affiliation(s)
- Thomas Pilgrim
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Martina Rothenbühler
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - George Cm Siontis
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Juan F Iglesias
- Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland
| | - Masahiko Asami
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Thierry Lefèvre
- Department of Interventional Cardiology, Hopital Jacques Cartier, Massy, France
| | - Raffaele Piccolo
- Division of Cardiology, Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy
| | | | - Shigeru Saito
- Division of Cardiology & Catheterization Laboratories, Shonan Kamakura General Hospital, Japan; Sapporo Higashi Tokushukai Hospital, Sapporo, Japan
| | | | - Olivier Muller
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Ron Waksman
- Division of Interventional Cardiology, MedStar Cardiovascular Research Network, MedStar Washington Hospital Center, Washington, DC
| | - Stephan Windecker
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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7
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Koolen J. Another Approach, Another Hope? Cardiovascular Revascularization Medicine 2020; 21:1155-1156. [DOI: 10.1016/j.carrev.2020.09.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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8
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Ueki Y, Räber L, Otsuka T, Rai H, Losdat S, Windecker S, Garcia-Garcia HM, Landmesser U, Koolen J, Byrne R, Haude M, Joner M. Mechanism of Drug-Eluting Absorbable Metal Scaffold Restenosis. Circ Cardiovasc Interv 2020; 13:e008657. [DOI: 10.1161/circinterventions.119.008657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background:
The pathomechanisms underlying restenosis of the bioabsorbable sirolimus-eluting metallic scaffold (Magmaris) remain unknown. Using serial optical coherence tomography, we investigated causes of restenosis, including the contribution of late scaffold recoil versus neointimal hyperplasia.
Methods:
Patients enrolled in BIOSOLVE-II undergoing serial angiography and optical coherence tomography (post-intervention and follow-up: 6 months and/or 1 year) were analyzed. Patients were divided into 2 groups according to angiographic in-scaffold late lumen loss (LLL) <0.5 or ≥0.5 mm. End points were late absolute scaffold recoil and neointimal hyperplasia area as assessed by optical coherence tomography.
Results:
Serial data were available for analysis from 70 patients (LLL <0.5 mm: n=41; LLL ≥0.5 mm: n=29). Patient and lesion characteristics were comparable, and there was no significant difference in mean and minimal scaffold area between groups at post-intervention. Late absolute scaffold recoil was less among patients with LLL <0.5 mm (0.53±0.68 mm
2
) compared with those with LLL ≥0.5 mm (1.48±1.20 mm
2
;
P
<0.001). Neointimal hyperplasia area was smaller among patients with LLL <0.5 mm at follow-up (1.47±0.33 mm
2
) compared with patients with LLL ≥0.5 mm (1.68±0.34 mm
2
;
P
=0.013). In a matched-frame analysis (post-intervention and follow-up), late absolute scaffold recoil varied according to the underlying plaque type (lipid: 0.63±1.23 mm
2
; calcified: 0.81±1.44 mm
2
; and fibrous: 1.20±1.52 mm
2
;
P
<0.001), while there was no difference with regards to neointimal hyperplasia area (
P
=0.132).
Conclusions:
In addition to neointimal hyperplasia, late scaffold recoil contributed significantly to LLL of sirolimus-eluting absorbable metal scaffolds. The extent of late scaffold recoil was dependent on the underlying plaque morphology and was the highest among fibrotic lesions.
Registration:
URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01960504.
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Affiliation(s)
- Yasushi Ueki
- Department of Cardiology, Bern University Hospital, Switzerland (Y.U., L.R., T.O., S.W.)
| | - Lorenz Räber
- Department of Cardiology, Bern University Hospital, Switzerland (Y.U., L.R., T.O., S.W.)
| | - Tatsuhiko Otsuka
- Department of Cardiology, Bern University Hospital, Switzerland (Y.U., L.R., T.O., S.W.)
| | - Himanshu Rai
- Deutsches Herzzentrum München, Technische Universität München, Germany (H.R., R.B., M.J.)
| | - Sylvain Losdat
- Institute of Social and Preventive Medicine and Clinical Trials Unit, University of Bern, Switzerland (S.L.)
| | - Stephan Windecker
- Department of Cardiology, Bern University Hospital, Switzerland (Y.U., L.R., T.O., S.W.)
| | | | - Ulf Landmesser
- Department of Cardiology, Charite Universitätsmedizin Berlin, Germany (U.L.)
| | - Jacques Koolen
- Department of Cardiology, Catharina Hospital, Eindhoven, the Netherlands (J.K.)
| | - Robert Byrne
- Deutsches Herzzentrum München, Technische Universität München, Germany (H.R., R.B., M.J.)
| | - Michael Haude
- Medical Clinic I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Germany (M.H.)
| | - Michael Joner
- Deutsches Herzzentrum München, Technische Universität München, Germany (H.R., R.B., M.J.)
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9
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Koolen J. First Larger-Scale Study of the Magnesium Absorbable Stent: How Does It Perform During Implantation? Cardiovasc Revasc Med 2019; 20:1146-1147. [PMID: 31870529 DOI: 10.1016/j.carrev.2019.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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10
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Koolen J. Resorbable Magnesium Scaffold in Coronary Bifurcations: Report of In Vitro Experiments – Is There a Role for Magnesium and In Vitro Testing? Cardiovascular Revascularization Medicine 2019; 20:832-833. [DOI: 10.1016/j.carrev.2019.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 08/12/2019] [Indexed: 10/25/2022]
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11
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Ueki Y, Raber L, Otsuka T, Losdat S, Windecker S, Garcia-Garcia H, Byrne R, Landmesser U, Koolen J, Waksman R, Haude M, Joner M. 122Mechanism and impact of lesion morphology on the late lumen loss of drug-eluting resorbable magnesium scaffolds: a serial optical coherence tomography study. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz747.0038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Resorbable Magnesium Scaffolds have demonstrated favourable clinical results with acceptable late lumen loss (LLL). However, the pathomechanisms influencing LLL of resorbable sirolimus-eluting metallic scaffold (Magmaris) have not been analyzed.
Purpose
Using serial optical coherence tomography (OCT), we investigated potential factors, i.e. the contribution of recoil versus neointimal hyperplasia (NIH).
Methods
Patients who were enrolled into BIOSOLVE-II, and underwent serial angiography and OCT (baseline and follow-up: 6-month and/or 1-year) were analyzed. Patients were divided into 2 groups based on angiographic in-scaffold LLL <0.5mm or ≥0.5mm. Endpoints were late absolute recoil and NIH area as assessed by OCT.
Results
A total of 70 patients (LLL <0.5mm: n=41, LLL ≥0.5mm: n=29) were serially analyzed. Patient and lesion characteristics were comparable and there was no significant difference in mean and minimal scaffold area between groups at baseline. Late absolute recoil was significantly smaller among patients with LLL <0.5mm (0.53±0.68 mm2) compared with those with LLL ≥0.5mm (1.48±1.20 mm2, P<0.001) (Figure). A small difference in NIH area at follow-up was observed (LLL <0.5mm: 1.47±0.33 mm2 vs. LLL ≥0.5mm: 1.68±0.34 mm2, P=0.013). In a matched-frame analysis (baseline and follow-up), late absolute recoil varied according to the underlying plaque type (lipid: 0.63±1.23 mm2, calcified: 0.81±1.44 mm2, and fibrous: 1.20±1.52 mm2, P<0.001), while there was no difference with regards to NIH area (P=0.132).
Conclusion
The main driver of late lumen loss of sirolimus-eluting absorbable metal scaffold was late scaffold recoil, while the contribution of NIH was modest. The degree of late scaffold recoil depended on the underlying plaque type and was highest among fibrotic lesions. Future studies will address the impact of procedural factors such as adequate lesion preparation and post-dilatation.
Acknowledgement/Funding
Biotronik
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Affiliation(s)
- Y Ueki
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - L Raber
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - T Otsuka
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - S Losdat
- University of Bern, Institute of Social and Preventive Medicine and Clinical Trials Unit, Bern, Switzerland
| | - S Windecker
- Preventive Cardiology & Sports Medicine, Inselspital Bern, Bern, Switzerland
| | - H Garcia-Garcia
- Medstar Research Institute, Section of Interventional Cardiology, Washington, United States of America
| | - R Byrne
- German Heart Center of Munich, Munich, Germany
| | | | - J Koolen
- Catharina Hospital, Department of Cardiology, Eindhoven, Netherlands (The)
| | - R Waksman
- Medstar Research Institute, Section of Interventional Cardiology, Washington, United States of America
| | - M Haude
- Lukas Hospital GmbH, Neuss, Germany
| | - M Joner
- German Heart Center of Munich, Munich, Germany
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Hideo-Kajita A, Garcia-Garcia HM, Haude M, Joner M, Koolen J, Ince H, Abizaid A, Toelg R, Lemos PA, von Birgelen C, Christiansen EH, Wijns W, Neumann FJ, Kaiser C, Eeckhout E, Teik LS, Escaned J, Azizi V, Kuku KO, Ozaki Y, Dan K, Waksman R. First Report of Edge Vascular Response at 12 Months of Magmaris, A Second-Generation Drug-Eluting Resorbable Magnesium Scaffold, Assessed by Grayscale Intravascular Ultrasound, Virtual Histology, and Optical Coherence Tomography. A Biosolve-II Trial Sub-Study. Cardiovasc Revasc Med 2019; 20:392-398. [PMID: 31079817 DOI: 10.1016/j.carrev.2019.02.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/11/2019] [Accepted: 02/13/2019] [Indexed: 02/06/2023]
Abstract
INTRODUCTION AND OBJECTIVE The edge vascular response (EVR) remains unknown in second generation drug-eluting Resorbable Magnesium Scaffold (RMS), such as Magmaris. The aim of the study was to evaluate tissue modifications in the RMS edges over time, assessed by different invasive imaging modalities. METHODS The patients treated with the device were assessed by optical coherence tomography (OCT), grayscale intravascular ultrasound (IVUS), and virtual histology IVUS at baseline and 12 months. The EVR study performed a segment- and frame-level analysis of the 5 mm segments proximal and distal of the actual RMS. RESULTS The segment-level grayscale IVUS (n = 10), virtual histology IVUS (n = 10), and OCT (n = 18) analysis did not show any significant changes after 12 months, except for a fibrous plaque area (FPA) reduction of 0.5mm2 (p = 0.017) in the proximal segment compared to baseline. In the frame-level analysis, IVUS evaluation revealed a vessel area decreased 2.80 ± 1.43 mm2 (p = 0.012) and 2.49 ± 1.53 mm2 (p = 0.022) in 2 proximal frames. This was accompanied by plaque area reduction of 0.88 ± 0.70 mm2 (p = 0.048) and a FPA decreased by 0.63 ± 0.48 mm2 (p = 0.004) in one proximal frame. In 1 distal frame, there was a dense calcium area reduction of 0.10 ± 0.12 mm2 (p = 0.045), FPA and fibrous fatty plaque increased 0.54 ± 0.53 mm2 (p = 0.023) and 0.17 ± 0.16 mm2 (p = 0.016), respectively. By OCT, there was a lumen area decrease of 0.76 ± 1.51 mm2 (p = 0.045) in a distal frame. CONCLUSION At 12 months, Magmaris EVR assessment does not show overall significant changes, except for a fibrous plaque area reduction in the proximal segment. This could be translated as a benign healing process at the edges of the RMS. SUMMARY The edge vascular response (EVR) remains unknown in second generation drug-eluting absorbable metal scaffolds (RMS), such as Magmaris. Patients treated with the device were assessed by multi invasive imaging modalities [i.e. optical coherence tomography (OCT), grayscale intravascular ultrasound (IVUS), and virtual histology IVUS] evaluating the tissue changes over time in the segment- and frame-level analysis of the 5 mm segments proximal and distal of the actual RMS. As a result, after 12 months, Magmaris EVR assessment does not show overall significant changes, except for a fibrous plaque area reduction in the proximal segment, translating a benign healing process at the edges of the RMS.
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Affiliation(s)
- Alexandre Hideo-Kajita
- Interventional Cardiology Department, MedStar Washington Hospital Center, Washington, DC, USA
| | - Hector M Garcia-Garcia
- Interventional Cardiology Department, MedStar Washington Hospital Center, Washington, DC, USA.
| | - Michael Haude
- Medical Clinic I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany
| | - Michael Joner
- Deutsches Herzzentrum Muenchen und Deutsches Zentrum fuer Herz-Kreislaufforschung e.V., Munich, Germany
| | - Jacques Koolen
- Cardiologie, Catharina Ziekenhuis, Eindhoven, the Netherlands
| | - Hüseyin Ince
- Vivantes Klinikum im Friedrichshain and Am Urban, Department of Cardiology, University of Rostock, Berlin, Germany
| | | | - Ralph Toelg
- Herzzentrum Segeberger Kliniken, Henstedt-Ulzburg, Germany
| | - Pedro A Lemos
- Instituto do Coração - HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Clemens von Birgelen
- Department of Cardiology, Medisch Spectrum Twente, Thoraxcentrum Twente, Enschede, the Netherlands
| | | | - William Wijns
- Cardiology Department, Cardiovascular Research Center Aalst, OLV Hospital, Aalst, Belgium
| | - Franz-Josef Neumann
- Klinik fur Kardiologie und Angiologie II, Universitats-Herzzentrum Freiburg - Bad Krozingen, Bad Krozingen, Germany
| | - Christoph Kaiser
- Department of Cardiology, University Hospital, Basel, Switzerland
| | - Eric Eeckhout
- Department of Cardiology, Lausanne University Hospital, Lausanne, Switzerland
| | - Lim Soo Teik
- Department of Cardiology, National Heart Center Singapore, Singapore, Singapore
| | - Javier Escaned
- Department of Cardiology, Hospital Clinico San Carlos, Madrid, Spain
| | - Viana Azizi
- Interventional Cardiology Department, MedStar Washington Hospital Center, Washington, DC, USA
| | - Kayode O Kuku
- Interventional Cardiology Department, MedStar Washington Hospital Center, Washington, DC, USA
| | - Yuichi Ozaki
- Interventional Cardiology Department, MedStar Washington Hospital Center, Washington, DC, USA
| | - Kazuhiro Dan
- Interventional Cardiology Department, MedStar Washington Hospital Center, Washington, DC, USA
| | - Ron Waksman
- Interventional Cardiology Department, MedStar Washington Hospital Center, Washington, DC, USA
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Koolen J. Do we need a guide for left main stenting? Cardiovascular Revascularization Medicine 2018; 19:731-732. [DOI: 10.1016/j.carrev.2018.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 11/30/2022]
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Holmes DR, King S, Gershlick AH, Marco J, Koolen J, Pichard A, Bassand JP, Kettles DI, Wijns W, Ntsekhe M. Invasive cardiovascular needs in South Africa: a view from afar up close. EUROINTERVENTION 2018; 14:852-855. [DOI: 10.4244/eijv14i8a153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Onuma Y, Grundeken MJ, Nakatani S, Asano T, Sotomi Y, Foin N, Ng J, Okamura T, Wykrzykowska JJ, de Winter RJ, van Geuns RJ, Koolen J, Christiansen EH, Whitbourn R, McClean D, Smits P, Windecker S, Ormiston JA, Serruys PW. Serial 5-Year Evaluation of Side Branches Jailed by Bioresorbable Vascular Scaffolds Using 3-Dimensional Optical Coherence Tomography: Insights From the ABSORB Cohort B Trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions). Circ Cardiovasc Interv 2018; 10:CIRCINTERVENTIONS.116.004393. [PMID: 28893770 DOI: 10.1161/circinterventions.116.004393] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 07/28/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND The long-term fate of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA) struts jailing side branch ostia has not been clarified. We therefore evaluate serially (post-procedure and at 6 months, 1, 2, 3, and 5 years) the appearance and fate of jailed Absorb bioresorbable vascular scaffold struts. METHODS AND RESULTS We performed 3-dimensional optical coherence tomographic analysis of the ABSORB Cohort B trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions) up to 5 years using a novel, validated cut-plane analysis method. We included 29 patients with a total of 85 side branch ostia. From the 12 ostia which could be assessed in true serial fashion, 7 showed a pattern of initial decrease in the ostial area free from struts, followed by an increase in strut-free ostial area toward the end of the 5 years of follow-up. In a repeated-measures analysis with time as fixed variable and ostial area free from struts as dependent variable, we showed a numeric decrease in the estimated ostial area free from struts from 0.75 mm2 (baseline) to 0.68 mm2 (first follow-up visit at 6 months or 1 year) and 0.63 mm2 (second follow-up visit at 2 or 3 years). However, from the second visit to the 5-year follow-up visit, there was a statistically significant increase from 0.63 to 0.89 mm2 (P=0.001). Struts overlying an ostium divided the ostium into compartments, and the number of these compartments decreased over time. CONCLUSIONS This study showed that in most cases, the side branch ostial area free from struts initially decreased. However, with full scaffold bioresorption, the ostial area free from scaffold increased between 2 to 3 years and 5 years in the vast majority of patients. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00856856.
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Affiliation(s)
- Yoshinobu Onuma
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Maik J Grundeken
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Shimpei Nakatani
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Taku Asano
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Yohei Sotomi
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Nicolas Foin
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Jaryl Ng
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Takayuki Okamura
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Joanna J Wykrzykowska
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Robbert J de Winter
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Robert-Jan van Geuns
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Jacques Koolen
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Evald H Christiansen
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Robert Whitbourn
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Dougal McClean
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Pieter Smits
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Stephan Windecker
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - John A Ormiston
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.)
| | - Patrick W Serruys
- From the Thoraxcenter, Erasmus MC, Rotterdam, the Netherlands (Y.O., S.N., R.-J.v.G.); Cardialysis, Rotterdam, the Netherlands (Y.O.); Academic Medical Center, University of Amsterdam, the Netherlands (M.J.G., T.A., Y.S., J.J.W., R.J.d.W.); National Heart Centre Singapore (N.F., J.N.); National University of Singapore (J.N.); Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi-Ube, Japan (T.O.); Catharina Ziekenhuis, Eindhoven, the Netherlands (J.K.); Skejby Sygehus, Aarhus, Denmark (E.C.); The Cardiovascular Research Centre, St. Vincents Hospital, Fitzroy, Australia (R.W.); Cardiology Department, Christchurch Hospital, New Zealand (D.M.); Division of Cardiology, Maasstad Ziekenhuis, Rotterdam, the Netherlands (P.S.); Division of Cardiology Swiss Cardiovascular Center, Bern, Switzerland (S.W.); Auckland City Hospital, New Zealand (J.A.O.); and International Center for Circulatory Health NHLI, Imperial College London, United Kingdom (P.W.S.).
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Kandzari DE, Mauri L, Koolen J, Massaro J, Doros G, Garcia HG, Cutlip D, Waksman R. BIOFLOW V: COMPARISON OF ULTRATHIN SIROLIMUS-ELUTING BIORESORBABLE POLYMER STENTS WITH THIN EVEROLIMUS-ELUTING DURABLE POLYMER STENTS - TARGET VESSEL MYOCARDIAL INFARCTION ANALYSIS. J Am Coll Cardiol 2018. [DOI: 10.1016/s0735-1097(18)31558-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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van der Nat PB, van Veghel D, Daeter E, Crijns HJ, Koolen J, Houterman S, Soliman MA, de Mol BA. Insights on value-based healthcare implementation from Dutch heart care. International Journal of Healthcare Management 2017. [DOI: 10.1080/20479700.2017.1397307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- P. B. van der Nat
- Value-Based Healthcare Department, St. Antonius Hospital, Nieuwegein, Netherlands
| | - D. van Veghel
- Heart Center, Catharina Hospital, Eindhoven, Netherlands
| | - E. Daeter
- Department of Cardiothoracic Surgery, St. Antonius Hospital, Nieuwegein, Netherlands
| | - H. J. Crijns
- Department of Cardiology, Maastricht University Medical Center, Maastricht, Netherlands
| | - J. Koolen
- Meetbaar Beter, Eindhoven, Netherlands
| | - S. Houterman
- Department of Education & Research, Catharina Hospital, Netherlands
| | - M. A. Soliman
- Department of Cardiothoracic Surgery, Catharina Hospital, Eindhoven, Netherlands
| | - B. A. de Mol
- AMC Heart Center, Department of Cardio-thoracic Surgery, Academic Medical Center at the University of Amsterdam, Amsterdam, Netherlands
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18
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Fajadet J, Haude M, Joner M, Koolen J, Lee M, Tölg R, Waksman R. Magmaris preliminary recommendation upon commercial launch: a consensus from the expert panel on 14 April 2016. EUROINTERVENTION 2017; 12:828-33. [PMID: 27639734 DOI: 10.4244/eijv12i7a137] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Bioresorbable scaffolds represent an exciting milestone in the development of coronary stent technology with the potential to substantially improve the management of patients with coronary artery disease. In an attempt to provide first recommendations for the technology, experienced experts involved in the first-in-man studies met in Zurich on the 14 April 2016 in order to reach consensus on a responsible market introduction. This document will be updated regularly as new information from clinical trials becomes available and should be understood as a review of current data, opportunities, expectations, advice, and recommendations for future investigations.
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Affiliation(s)
- Jean Fajadet
- Department of Interventional Cardiology, Clinique Pasteur, Toulouse, France
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Everaert B, Wykrzykowska JJ, Koolen J, van der Harst P, den Heijer P, Henriques JP, van der Schaaf R, de Smet B, Hofma SH, Diletti R, Weevers A, Hoorntje J, Smits P, van Geuns RJ. Recommendations for the use of bioresorbable vascular scaffolds in percutaneous coronary interventions : 2017 revision. Neth Heart J 2017; 25:419-428. [PMID: 28643297 PMCID: PMC5513994 DOI: 10.1007/s12471-017-1014-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND To eliminate some of the potential late limitations of permanent metallic stents, the bioresorbable coronary stents or 'bioresorbable vascular scaffolds' (BVS) have been developed. METHODS We reviewed all currently available clinical data on BVS implantation. RESULTS Since the 2015 position statement on the appropriateness of BVS in percutaneous coronary interventions, several large randomised trials have been presented. These have demonstrated that achieving adequate 1 and 2 year outcomes with these first-generation BVS is not straightforward. These first adequately powered studies in non-complex lesions showed worse results if standard implantation techniques were used for these relatively thick scaffolds. Post-hoc analyses hypothesise that outcomes similar to current drug-eluting stents are still possible if aggressive lesion preparation, adequate sizing and high-pressure postdilatation are implemented rigorously. As long as this has not been confirmed in prospective studies the usage should be restricted to experienced centres with continuous outcome monitoring. For more complex lesions, results are even more disappointing and usage should be discouraged. When developed, newer generation scaffolds with thinner struts or faster resorption rates are expected to improve outcomes. In the meantime prolonged dual antiplatelet therapy (DAPT, beyond one year) is recommended in an individualised approach for patients treated with current generation BVS. CONCLUSION The new 2017 recommendations downgrade and limit the use of the current BVS to experienced centres within dedicated registries using the updated implantation protocol and advise the prolonged usage of DAPT. In line with these recommendations the manufacturer does not supply devices to the hospitals without such registries in place.
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Affiliation(s)
- B Everaert
- Thoraxcenter, Erasmus Medical Centre, Rotterdam, The Netherlands
- Monica Hospital, Antwerp, Belgium
| | | | - J Koolen
- Catharina Hospital, Eindhoven, The Netherlands
| | - P van der Harst
- University Medical Center, University of Groningen, Groningen, The Netherlands
| | | | | | | | - B de Smet
- Meander Medical Center, Amersfoort, The Netherlands
| | - S H Hofma
- Medical Center, Leeuwarden, The Netherlands
| | - R Diletti
- Thoraxcenter, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - A Weevers
- Albert Schweitzer Hospital, Dordrecht, The Netherlands
| | - J Hoorntje
- Maastricht University Medical Center, Maastricht, The Netherlands
| | - P Smits
- Maasstad Hospital, Rotterdam, The Netherlands
| | - R J van Geuns
- Thoraxcenter, Erasmus Medical Centre, Rotterdam, The Netherlands.
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20
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Haude M, Erbel R, Erne P, Verheye S, Degen H, Vermeersch P, Weissman N, Prati F, Bruining N, Waksman R, Koolen J. Safety and performance of the DRug-Eluting Absorbable Metal Scaffold (DREAMS) in patients with de novo coronary lesions: 3-year results of the prospective, multicentre, first-in-man BIOSOLVE-I trial. EUROINTERVENTION 2017; 12:e160-6. [PMID: 27290675 DOI: 10.4244/eij-d-15-00371] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
AIMS Bioresorbable scaffolds were designed to overcome the limitations of permanent stents. In the BIOSOLVE-I study we aimed to assess the long-term safety and performance of a drug-eluting absorbable metal scaffold (DREAMS) at three years. METHODS AND RESULTS In this prospective, multicentre first-in-man study, 46 patients with 47 de novo lesions were enrolled. We report the final results at three-year follow-up. Mean age was 65.3±9.7 years, lesions were 2.73±0.48 mm in diameter and 10.99±4.59 mm long. Follow-up at three years was available for 44 patients (one patient died of a non-cardiac cause and one patient withdrew consent). Three target lesion failures (TLF) occurred (6.6%), consisting of two clinically driven target lesion revascularisations at scheduled six-month angiography (4.3%) and one myocardial infarction after drug-eluting balloon treatment in a non-target lesion but target vessel at 12-month angiography (2.2%). No cardiac death or scaffold thrombosis occurred. Seven patients had additional angiographic follow-up at 28±4 months: in-scaffold late lumen loss had improved from 0.51±0.46 mm (median 0.28 mm) at 12 months to 0.32±0.32 mm (median 0.20 mm). CONCLUSIONS The BIOSOLVE-I study showed excellent long-term outcomes at three years with a low TLF rate and no cardiac death or scaffold thrombosis. No TLF event was observed beyond 377 days.
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Affiliation(s)
- Michael Haude
- Medical Clinic I, Städtische Kliniken-Neuss, Lukaskrankenhaus GmbH, Neuss, Germany
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21
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Pijls NHJ, Leus SJL, Zimmermann FM, van Nunen LX, Van't Veer M, Koolen J, van Hagen E. Stenting of bifurcation lesions. Neth Heart J 2017; 25:290-291. [PMID: 28265977 PMCID: PMC5355394 DOI: 10.1007/s12471-017-0973-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- N H J Pijls
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands.
| | - S J L Leus
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - F M Zimmermann
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - L X van Nunen
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - M Van't Veer
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - J Koolen
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
| | - E van Hagen
- Department of Cardiology, Catharina Hospital Eindhoven, Eindhoven, The Netherlands
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22
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Onuma Y, Collet C, van Geuns RJ, de Bruyne B, Christiansen E, Koolen J, Smits P, Chevalier B, McClean D, Dudek D, Windecker S, Meredith I, Nieman K, Veldhof S, Ormiston J, Serruys PW. Long-term serial non-invasive multislice computed tomography angiography with functional evaluation after coronary implantation of a bioresorbable everolimus-eluting scaffold: the ABSORB cohort B MSCT substudy. Eur Heart J Cardiovasc Imaging 2017; 18:870-879. [DOI: 10.1093/ehjci/jex022] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 02/01/2017] [Indexed: 12/31/2022] Open
Affiliation(s)
- Yoshinobu Onuma
- Department of Interventional Cardiology, ThoraxCenter, Erasmus University Medical Center,’s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
- Cardiology Department, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam-Zuidoost, Amsterdam, The Netherlands
| | - Carlos Collet
- Cardiology Department, Academic Medical Center, Amsterdam, Cardialysis, Westblaak 98, 3012 KM Rotterdam, The Netherlands
| | - Robert-Jan van Geuns
- Department of Interventional Cardiology, ThoraxCenter, Erasmus University Medical Center,’s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
| | - Bernard de Bruyne
- Department of Cardiology, Onze-Lieve-Vrouwziekenhuis, Moorselbaan 164, 9300 Aalst, Belgium
| | - Evald Christiansen
- Department of Cardiology, Skejby Sygehus, Aarhus Universitet Skejby Sygehus, Brendstrupgårdsvej 100, 8200 Aarhus N, Denmark
| | - Jacques Koolen
- Department of Cardiology, Catharina Ziekenhuis, Michelangelolaan 2, 5623 EJ Eindhoven, the Netherlands
| | - Pieter Smits
- Department of Cardiology, Maasstad Ziekenhuis, Maasstadweg 21, 3079 DZ, Rotterdam, the Netherlands
| | - Bernard Chevalier
- Department of Interventional Cardiology, Institut Hospital Jacques Cartier, 6 Avenue du Noyer Lambert, 91300 Massy, France
| | - Dougal McClean
- Department of Cardiology, Christchurch Hospital, 2 Riccarton Ave, Christchurch Central, Christchurch 4710, New Zealand
| | - Dariusz Dudek
- Jagiellonian University Institute of Cardiology, University Hospital Krakow, Mikołaja Kopernika 36, 31-501 Kraków, Poland
| | - Stephan Windecker
- Universitätsklinik für Kardiologie, Inselspital, Freiburgstrasse 4, 3010 Bern, Switzerland
| | - Ian Meredith
- Monash Heart, Monash Medical Centre, 246 Clayton Rd, Clayton VIC 3168, Melbourne, Australia
| | - Koen Nieman
- Department of Interventional Cardiology, ThoraxCenter, Erasmus University Medical Center,’s-Gravendijkwal 230, 3015 CE Rotterdam, The Netherlands
- Cardiology Department, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam-Zuidoost, Amsterdam, The Netherlands
| | - Susan Veldhof
- Clinical Development, Abbott Vascular, Diegem, Belgium
| | - John Ormiston
- Department of Cardiology, Auckland City Hospital, 2 Park Rd, Grafton, Auckland 1023, New Zealand
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Zeng Y, Tateishi H, Cavalcante R, Tenekecioglu E, Suwannasom P, Sotomi Y, Collet C, Nie S, Jonker H, Dijkstra J, Radu MD, Räber L, McClean DR, van Geuns RJ, Christiansen EH, Fahrni T, Koolen J, Onuma Y, Bruining N, Serruys PW. Serial Assessment of Tissue Precursors and Progression of Coronary Calcification Analyzed by Fusion of IVUS and OCT: 5-Year Follow-Up of Scaffolded and Nonscaffolded Arteries. JACC Cardiovasc Imaging 2017; 10:1151-1161. [PMID: 28330651 DOI: 10.1016/j.jcmg.2016.11.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/07/2016] [Accepted: 11/10/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The aim of this study was to assess calcium growth with fused grayscale intravascular ultrasound (IVUS), IVUS-virtual histology, and optical coherence tomography (OCT) from baseline to 5-year follow-up in patients treated with bioresorbable vascular scaffolds. BACKGROUND IVUS and OCT have individual strengths in assessing plaque composition and volume. Fusion of images obtained using these methods could potentially aid in coronary plaque assessment. METHODS Anatomic landmarks and endoluminal radiopaque markers were used to fuse OCT and IVUS images and match baseline and follow-up. RESULTS Seventy-two IVUS-virtual histology and OCT paired matched cross-sectional in- and out-scaffold segments were fused at baseline and follow-up. In total, 46 calcified plaques at follow-up were detected using the fusion method (33 in-scaffold, 13 out-scaffold), showing either calcium progression (52.2%) or de novo calcifications (47.8%). On OCT, calcification volume increased from baseline to follow-up by 2.3 ± 2.4 mm3 (p = 0.001). The baseline virtual histologic tissue precursors of dense calcium at follow-up were necrotic core in 73.9% and fibrous or fibrofatty plaque in 10.9%. In 15.2%, calcium was already present at baseline. Precursors on OCT were lipid pool in 71.2%, fibrous plaque in 4.3%, and fibrocalcific plaque in 23.9%. CONCLUSIONS The use of OCT and IVUS fusion imaging shows similar calcium growth in- and out-scaffold segments. Necrotic core is the most frequent precursor of calcification. The scaffold resorption process creates a tissue layer that re-caps the calcified plaques. (Absorb Clinical Investigation, Cohort B [ABSORB B]; NCT00856856).
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Affiliation(s)
- Yaping Zeng
- ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands; The Emergency & Critical Care Center of Beijing Anzhen Hospital, Capital Medical University, Beijing, the People's Republic of China
| | - Hiroki Tateishi
- ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands
| | | | | | - Pannipa Suwannasom
- ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands; Academic Medical Center, Amsterdam, the Netherlands
| | - Yohei Sotomi
- Academic Medical Center, Amsterdam, the Netherlands
| | | | - Shaoping Nie
- The Emergency & Critical Care Center of Beijing Anzhen Hospital, Capital Medical University, Beijing, the People's Republic of China
| | | | - Jouke Dijkstra
- Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands
| | - Maria D Radu
- ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
| | - Lorenz Räber
- ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands; Department of Cardiology, Bern University Hospital, Bern, Switzerland
| | - Dougal R McClean
- Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand
| | | | - Evald H Christiansen
- Department of Cardiology, Aarhus University Hospital, Skejby Hospital, Aarhus, Denmark
| | - Therese Fahrni
- Department of Cardiology, Swiss Cardiovascular Center, University Hospital, Bern, Switzerland
| | - Jacques Koolen
- Cardiology, Catharina Ziekenhuis, Eindhoven, the Netherlands
| | - Yoshinobu Onuma
- ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Nico Bruining
- ThoraxCentre, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Patrick W Serruys
- International Centre for Circulatory Health, Imperial College, London, United Kingdom.
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Zeng Y, Tateishi H, Cavalcante R, TENEKECIOGLU ERHAN, Suwannasom P, Sotomi Y, Collet C, Nie SP, Jonker H, Dijkstra J, Radu M, Raber L, Mcclean D, Geuns RJV, Christiansen E, Therese F, Koolen J, Onuma Y, Serruys P. TCT-552 SERIAL ASSESSMENT OF CALCIFICATION 5 YEARS AFTER BIORESORBABLE VASCULAR SCAFFOLD IMPLANTATION: FUSION OF INTRAVASCULAR ULTRASOUND AND OPTICAL COHERENCE TOMOGRAPHY. J Am Coll Cardiol 2016. [DOI: 10.1016/j.jacc.2016.09.690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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25
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Leus SJL, van Hagen E, Zimmermann FM, van Nunen LX, van ‘t Veer M, Koolen J, Pijls NHJ. Evaluation of bifurcation stenting techniques at Catharina Hospital, Eindhoven in 2013. Neth Heart J 2016; 25:40-46. [PMID: 27785622 PMCID: PMC5179365 DOI: 10.1007/s12471-016-0911-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Serruys PW, Ormiston J, van Geuns RJ, de Bruyne B, Dudek D, Christiansen E, Chevalier B, Smits P, McClean D, Koolen J, Windecker S, Whitbourn R, Meredith I, Wasungu L, Ediebah D, Veldhof S, Onuma Y. A Polylactide Bioresorbable Scaffold Eluting Everolimus for Treatment of Coronary Stenosis: 5-Year Follow-Up. J Am Coll Cardiol 2016; 67:766-76. [PMID: 26892411 DOI: 10.1016/j.jacc.2015.11.060] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 10/26/2015] [Accepted: 11/11/2015] [Indexed: 12/27/2022]
Abstract
BACKGROUND Long-term benefits of coronary stenosis treatment with an everolimus-eluting bioresorbable scaffold are unknown. OBJECTIVES This study sought to evaluate clinical and imaging outcomes 5 years after bioresorbable scaffold implantation. METHODS In the ABSORB multicenter, single-arm trial, 45 (B1) and 56 patients (B2) underwent coronary angiography, intravascular ultrasound (IVUS), and optical coherence tomography (OCT) at different times. At 5 years, 53 patients without target lesion revascularization underwent final imaging. RESULTS Between 6 months/1 year and 5 years, angiographic luminal late loss remained unchanged (B1: 0.14 ± 19 mm vs. 0.13 ± 0.33 mm; p = 0.7953; B2: 0.23 ± 0.28 mm vs. 0.18 ± 0.32 mm; p = 0.5685). When patients with a target lesion revascularization were included, luminal late loss was 0.15 ± 0.20 mm versus 0.15 ± 0.24 mm (p = 0.8275) for B1 and 0.30 ± 0.37 mm versus 0.32 ± 0.48 mm (p = 0.8204) for B2. At 5 years, in-scaffold and -segment binary restenosis was 7.8% (5 of 64) and 12.5% (8 of 64). On IVUS, the minimum lumen area of B1 decreased from 5.23 ± 0.97 mm(2) at 6 months to 4.89 ± 1.81 mm(2) at 5 years (p = 0.04), but remained unchanged in B2 (4.95 ± 0.91 mm(2) at 1 year to 4.84 ± 1.28 mm(2) at 5 years; p = 0.5). At 5 years, struts were no longer discernable by OCT and IVUS. On OCT, the minimum lumen area in B1 decreased from 4.51 ± 1.28 mm(2) at 6 months to 3.65 ± 1.39 mm(2) at 5 years (p = 0.01), but remained unchanged in B2, 4.35 ± 1.09 mm(2) at 1 year and 4.12 ± 1.38 mm(2) at 5 years (p = 0.24). Overall, the 5-year major adverse cardiac event rate was 11.0%, without any scaffold thrombosis. CONCLUSIONS At 5 years, bioresorbable scaffold implantation in a simple stenotic lesion resulted in stable lumen dimensions and low restenosis and major adverse cardiac event rates. (ABSORB Clinical Investigation, Cohort B [ABSORB B]; NCT00856856).
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Affiliation(s)
- Patrick W Serruys
- International Center for Circulatory Health, National Heart and Lung Institute, Imperial College, London, United Kingdom.
| | - John Ormiston
- Cardiology Department, Auckland City Hospital, Auckland, New Zealand
| | | | | | - Dariusz Dudek
- Jagiellonian University Institute of Cardiology, University Hospital Krakow, Krakow, Poland
| | | | - Bernard Chevalier
- Interventional Cardiology, Institut Hospital Jacques Cartier, Massy, France
| | - Pieter Smits
- Cardiologie, Maasstad Ziekenhuis, Rotterdam, the Netherlands
| | - Dougal McClean
- Interventional Cardiology, Christchurch Hospital, Christchurch, New Zealand
| | - Jacques Koolen
- Cardiologie, Catharina Ziekenhuis, Eindhoven, the Netherlands
| | | | - Robert Whitbourn
- Cardiac Catheterisation Lab & Coronary Intervention, Saint Vincent's Hospital Melbourne, Fitzroy, Australia
| | - Ian Meredith
- Monash Heart, Monash Medical Centre, Melbourne, Australia
| | - Luc Wasungu
- Clinical Development, Abbott Vascular, Diegem, Belgium
| | | | - Susan Veldhof
- Clinical Development, Abbott Vascular, Diegem, Belgium
| | - Yoshinobu Onuma
- ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands
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27
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Gogas BD, Bourantas CV, Garcia-Garcia HM, Onuma Y, Muramatsu T, Farooq V, Diletti R, van Geuns RJM, De Bruyne B, Chevalier B, Thuesen L, Smits PC, Dudek D, Koolen J, Windecker S, Whitbourn R, McClean D, Dorange C, Miquel-Hebert K, Veldhof S, Rapoza R, Ormiston JA, Serruys PW. The edge vascular response following implantation of the Absorb everolimus-eluting bioresorbable vascular scaffold and the XIENCE V metallic everolimus-eluting stent. First serial follow-up assessment at six months and two years: insights from the first-in-man ABSORB Cohort B and SPIRIT II trials. EUROINTERVENTION 2016; 9:709-20. [PMID: 23628499 DOI: 10.4244/eijv9i6a115] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
AIMS To assess serially the edge vascular response (EVR) of a bioresorbable vascular scaffold (BVS) compared to a metallic everolimus-eluting stent (EES). METHODS AND RESULTS Non-serial evaluations of the Absorb BVS at one year have previously demonstrated proximal edge constrictive remodelling and distal edge changes in plaque composition with increase of the percent fibro-fatty (FF) tissue component. The 5 mm proximal and distal segments adjacent to the implanted devices were investigated serially with intravascular ultrasound (IVUS), post procedure, at six months and at two years, from the ABSORB Cohort B1 (n=45) and the SPIRIT II (n=113) trials. Twenty-two proximal and twenty-four distal edge segments were available for analysis in the ABSORB Cohort B1 trial. In the SPIRIT II trial, thirty-three proximal and forty-six distal edge segments were analysed. At the 5-mm proximal edge, the vessels treated with an Absorb BVS from post procedure to two years demonstrated a lumen loss (LL) of 6.68% (-17.33; 2.08) (p=0.027) with a trend toward plaque area increase of 7.55% (-4.68; 27.11) (p=0.06). At the 5-mm distal edge no major changes were evident at either time point. At the 5-mm proximal edge the vessels treated with a XIENCE V EES from post procedure to two years did not show any signs of LL, only plaque area decrease of 6.90% (-17.86; 4.23) (p=0.035). At the distal edge no major changes were evident with regard to either lumen area or vessel remodelling at the same time point. CONCLUSIONS The IVUS-based serial evaluation of the EVR up to two years following implantation of a bioresorbable everolimus-eluting scaffold shows a statistically significant proximal edge LL; however, this finding did not seem to have any clinical implications in the serial assessment. The upcoming imaging follow-up of the Absorb BVS at three years is anticipated to provide further information regarding the vessel wall behaviour at the edges.
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Affiliation(s)
- Bill D Gogas
- Thoraxcenter, Erasmus University Medical Center, Rotterdam, The Netherlands
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Bourantas CV, Serruys PW, Nakatani S, Zhang YJ, Farooq V, Diletti R, Ligthart J, Sheehy A, van Geuns RJM, McClean D, Chevalier B, Windecker S, Koolen J, Ormiston J, Whitbourn R, Rapoza R, Veldhof S, Onuma Y, Garcia-Garcia HM. Bioresorbable vascular scaffold treatment induces the formation of neointimal cap that seals the underlying plaque without compromising the luminal dimensions: a concept based on serial optical coherence tomography data. EUROINTERVENTION 2015; 11:746-56. [DOI: 10.4244/eijy14m10_06] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Serruys PW, Onuma Y, Van Geuns RJ, De Bruyne B, Dudek D, Christiansen EH, Chevalier B, Smits PC, McCLean D, Koolen J, Windecker S, Whitbourn RJ, Meredith IT, Wasungu L, Ediebah DE, Veldhof S, Ormiston JA. TCT-11 Five-year Follow up of the First in Man use of a Polylactide Bioresorbable Scaffold Eluting Everolimus for Treatment of Coronary Stenosis; A Serial Multi-Imaging Modality Study. J Am Coll Cardiol 2015. [DOI: 10.1016/j.jacc.2015.08.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Vranckx P, Leebeek FWG, Tijssen JGP, Koolen J, Stammen F, Herman JPR, de Winter RJ, van T Hof AWJ, Backx B, Lindeboom W, Kim SY, Kirsch B, van Eickels M, Misselwitz F, Verheugt FWA. Peri-procedural use of rivaroxaban in elective percutaneous coronary intervention to treat stable coronary artery disease. The X-PLORER trial. Thromb Haemost 2015; 114:258-67. [PMID: 25925992 DOI: 10.1160/th15-01-0061] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/04/2015] [Indexed: 12/12/2022]
Abstract
Patients on rivaroxaban requiring percutaneous coronary intervention (PCI) represent a clinical conundrum. We aimed to investigate whether rivaroxaban, with or without an additional bolus of unfractionated heparin (UFH), effectively inhibits coagulation activation during PCI. Stable patients (n=108) undergoing elective PCI and on stable dual antiplatelet therapy were randomised (2:2:2:1) to a short treatment course of rivaroxaban 10 mg (n=30), rivaroxaban 20 mg (n=32), rivaroxaban 10 mg plus UFH (n=30) or standard peri-procedural UFH (n=16). Blood samples for markers of thrombin generation and coagulation activation were drawn prior to and at 0, 0.5, 2, 6-8 and 48 hours (h) after start of PCI. In patients treated with rivaroxaban (10 or 20 mg) and patients treated with rivaroxaban plus heparin, the levels of prothrombin fragment 1 + 2 at 2 h post-PCI were 0.16 [0.1] nmol/l (median) [interquartile range, IQR] and 0.17 [0.2] nmol/l, respectively. Thrombin-antithrombin complex values at 2 h post-PCI were 3.90 [6.8]µg/l and 3.90 [10.1] µg/l, respectively, remaining below the upper reference limit (URL) after PCI and stenting. This was comparable to the control group of UFH treatment alone. However, median values for thrombin-antithrombin complex passed above the URL with increasing tendency, starting at 2 h post-PCI in the UFH-alone arm but not in rivaroxaban-treated patients. In this exploratory trial, rivaroxaban effectively suppressed coagulation activation after elective PCI and stenting.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - F W A Verheugt
- Prof. Freek W. A. Verheugt MD, PhD, Department of Cardiology, Heartcenter, Oosterpark 9, AC Amsterdam 1091, the Netherlands, Tel.: + 31 20 5993421, Fax: +31 20 5993997, E-mail: f. w.
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Everaert B, Felix C, Koolen J, den Heijer P, Henriques J, Wykrzykowska J, van der Schaaf R, de Smet B, Hofma S, Diletti R, Van Mieghem N, Regar E, Smits P, van Geuns RJM. Appropriate use of bioresorbable vascular scaffolds in percutaneous coronary interventions: a recommendation from experienced users : A position statement on the use of bioresorbable vascular scaffolds in the Netherlands. Neth Heart J 2015; 23:161-5. [PMID: 25626696 PMCID: PMC4352153 DOI: 10.1007/s12471-015-0651-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Percutaneous coronary interventions (PCI) have become a reliable revascularisation option to treat ischaemic coronary artery disease. Drug-eluting stents (DES) are widely used as first choice devices in many procedures due to their established good medium to long term outcomes. These permanent implants, however, do not have any residual function after vascular healing following the PCI. Beyond this initial healing period, metallic stents may induce new problems, resulting in an average rate of 2 % reinterventions per year. To eliminate this potential late limitation of permanent metallic DES, bioresorbable coronary stents or ‘vascular scaffolds’ (BVS) have been developed. In a parallel publication in this journal, an overview of the current clinical performance of these scaffolds is presented. As these scaffolds are currently CE marked and commercially available in many countries and as clinical evidence is still limited, recommendations for their general usage are needed to allow successful clinical introduction.
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Affiliation(s)
- Bert Everaert
- Thoraxcenter, Erasmus Medical Centre, 's-Gravendijkwal 230, 3015 GE, Rotterdam, The Netherlands,
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Bourantas CV, Farooq V, Zhang Y, Muramatsu T, Gogas BD, Thuesen L, McClean D, Chevalier B, Windecker S, Koolen J, Ormiston J, Whitbourn R, Dorange C, Rapoza R, Onuma Y, Garcia-Garcia HM, Serruys PW. Circumferential distribution of the neointima at six-month and two-year follow-up after a bioresorbable vascular scaffold implantation: a substudy of the ABSORB Cohort B Clinical Trial. EUROINTERVENTION 2015; 10:1299-306. [DOI: 10.4244/eijy14m04_11] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Haude M, Erbel R, Erne P, Verheye S, Vermeersch P, Degen H, Böse D, Waksman R, Weissmann NJ, Prati F, Koolen J. CRT-715 Long Term Clinical Data Of The BIOSOLVE-I Study With The Paclitaxel-eluting Absorbable Magnesium Scaffold (DREAMS) And Multi-modality Imaging Analysis. JACC Cardiovasc Interv 2015. [DOI: 10.1016/j.jcin.2014.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Serruys PW, Onuma Y, Garcia-Garcia HM, Muramatsu T, van Geuns RJ, de Bruyne B, Dudek D, Thuesen L, Smits PC, Chevalier B, McClean D, Koolen J, Windecker S, Whitbourn R, Meredith I, Dorange C, Veldhof S, Hebert KM, Rapoza R, Ormiston JA. Dynamics of vessel wall changes following the implantation of the absorb everolimus-eluting bioresorbable vascular scaffold: a multi-imaging modality study at 6, 12, 24 and 36 months. EUROINTERVENTION 2014; 9:1271-84. [PMID: 24291783 DOI: 10.4244/eijv9i11a217] [Citation(s) in RCA: 194] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
AIMS To assess observations with multimodality imaging of the Absorb bioresorbable everolimus-eluting vascular scaffold performed in two consecutive cohorts of patients who were serially investigated either at 6 and 24 months or at 12 and 36 months. METHODS AND RESULTS In the ABSORB multicentre single-arm trial, 45 patients (cohort B1) and 56 patients (cohort B2) underwent serial invasive imaging, specifically quantitative coronary angiography (QCA), intravascular ultrasound (IVUS), radiofrequency backscattering (IVUS-VH) and optical coherence tomography (OCT). Between one and three years, late luminal loss remained unchanged (6 months: 0.19 mm, 1 year: 0.27 mm, 2 years: 0.27 mm, 3 years: 0.29 mm) and the in-segment angiographic restenosis rate for the entire cohort B (n=101) at three years was 6%. On IVUS, mean lumen, scaffold, plaque and vessel area showed enlargement up to two years. Mean lumen and scaffold area remained stable between two and three years whereas significant reduction in plaque behind the struts occurred with a trend toward adaptive restrictive remodelling of EEM. Hyperechogenicity of the vessel wall, a surrogate of the bioresorption process, decreased from 23.1% to 10.4% with a reduction of radiofrequency backscattering for dense calcium and necrotic core. At three years, the count of strut cores detected on OCT increased significantly, probably reflecting the dismantling of the scaffold; 98% of struts were covered. In the entire cohort B (n=101), the three-year major adverse cardiac event rate was 10.0% without any scaffold thrombosis. CONCLUSIONS The current investigation demonstrated the dynamics of vessel wall changes after implantation of a bioresorbable scaffold, resulting at three years in stable luminal dimensions, a low restenosis rate and a low clinical major adverse cardiac events rate. CLINICAL TRIAL REGISTRATION INFORMATION http://www.clinicaltrials.gov/ct2/show/NCT00856856.
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Haude M, Erbel R, Erne P, Verheye S, Vermeersch P, Degen H, Boese D, Waksman R, Weissman N, Prati F, Koolen J. TCT-625 Long term clinical data of the BIOSOLVE-I study with the paclitaxel-eluting absorbable magnesium scaffold (DREAMS) and multi-modality imaging analysis. J Am Coll Cardiol 2014. [DOI: 10.1016/j.jacc.2014.07.690] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Nakatani S, Onuma Y, Ishibashi Y, van Geuns R, De Bruyne B, Dudek D, Christiansen E, Smits P, Chevalier B, McClean D, Koolen J, Windecker S, Meredith I, Perkins L, Rapoza R, Garcia HG, Ormiston J, Serruys P. SEQUENTIAL OPTICAL COHERENCE TOMOGRAPHY IMAGING POST PROCEDURE, AT 6, 12, 24 AND 36 MONTHS IN THE ABSORB COHORT B TRIAL: A LIGHT INTENSITY ANALYSIS TO ASSESS THE BIORESORPTION PROCESS OF EVEROLIMUS-ELUTING PLLA SCAFFOLD. J Am Coll Cardiol 2014. [DOI: 10.1016/s0735-1097(14)61884-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Brener SJ, Dambrink JH, Maehara A, Chowdhary S, Gershlick AH, Genereux P, Koolen J, Mehran R, Fahy M, Gibson CM, Stone GW. Benefits of optimising coronary flow before stenting in primary percutaneous coronary intervention for ST-elevation myocardial infarction: insights from INFUSE-AMI. EUROINTERVENTION 2014; 9:1195-201. [DOI: 10.4244/eijv9i10a201] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Waksman R, Prati F, Bruining N, Haude M, Böse D, Kitabata H, Erne P, Verheye S, Degen H, Vermeersch P, Di Vito L, Koolen J, Erbel R. Serial observation of drug-eluting absorbable metal scaffold: multi-imaging modality assessment. Circ Cardiovasc Interv 2013; 6:644-53. [PMID: 24254708 DOI: 10.1161/circinterventions.113.000693] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The drug-eluting absorbable metal scaffold has demonstrated feasibility, safety, and promising clinical and angiographic outcomes at 12 months in human coronary arteries. This study aimed to evaluate the degradation rate and long-term vascular responses to drug-eluting absorbable metal scaffold. METHODS AND RESULTS BIOSOLVE-I was a multicenter, single-arm, first-in-man trial assessing the safety and performance of drug-eluting absorbable metal scaffold in 46 patients with coronary artery disease. Patients who underwent serial invasive imaging, such as quantitative coronary angiography, intravascular ultrasound, and optical coherence tomography, at 6 and 12 months were included in this study. From postimplantation to follow-up, arterial curvature and angulation were significantly increased by the degradation process. The greatest increase was seen from postimplantation to 6 months. The systolic-diastolic changes of the curvature and angulation gradually improved throughout the follow-up period. At the site of implantation, vasoconstriction (-10% mean reduction) was observed during the acetylcholine test at 6 months. The average percent hyperechogenicity of the scaffolded segments showed a continuous decrease over time, with the most pronounced changes within the first 6 months (from 22.1±7.0% to 15.8±3.7%; P<0.001). Struts discernible on optical coherence tomography at 6 and 12 months showed full neointimal coverage, with stabilization of the mean scaffold area from 6 to 12 months. Furthermore, the mean neointimal area (1.55±0.51 versus 1.58±0.34 mm(2); P=0.794) remained unchanged from 6 to 12 months. CONCLUSIONS This serial analysis of drug-eluting absorbable metal scaffold confirmed the safety and efficacy of this new device, with vasomotion restoration and continued degradation over time demonstrated by multi-invasive imaging modalities. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT01168830.
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Affiliation(s)
- Ron Waksman
- From the Department of Cardiology, MedStar Washington Hospital Center, Washington, DC (R.W., H.K.); CLI Foundation, Ettore Sansavini Health Science Foundation, Rome, Italy (F.P., L.D.V.); Department of Cardiology, Erasmus MC, Thoraxcenter, Rotterdam, The Netherlands (N.B.); Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Medical Clinic I, Neuss, Germany (M.H., H.D.); Department of Cardiology, West German Heart Center Essen, Essen, Germany (D.B., R.E.); Department of Cardiology, Luzerner Kantonsspital, Lucerne, Switzerland (P.E.); Department of Cardiology, ZNA Middelheim, Antwerp, Belgium (S.V., P.V.); and Department of Cardiology, Catharina Hospital, Eindhoven, The Netherlands (J.K.)
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Haude M, Bruining N, Erbel R, Erne P, Verheye S, Vermeersch P, Degen H, Boese D, Waksman R, Koolen J. TCT-557 IVUS Echogenicity Analysis of the Paclitaxel-Eluting Absorbable Magnesium Scaffold (DREAMS). J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.1304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Onuma Y, Serruys PW, Muramatsu T, Nakatani S, Van Geuns RJ, De Bruyne B, Dudek D, Thuesen L, Smits PC, Chevalier B, Koolen J, Windecker S, Whitbourn RJ, Meredith IT, Garcia-Garcia HM, Veldhof S, Rapoza R, Ormiston JA. TCT-592 Incidence, imaging and clinical outcomes of acute scaffold disruption and late structural discontinuity after implantation of the Absorb everolimus-eluting fully bioresorbable vascular scaffold: Optical coherence tomography assessment in the ABSORB Cohort B trial. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.1339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Nakatani S, Onuma Y, Muramatsu T, Ishibashi Y, Van Geuns RJ, Chevalier B, Dudek D, Thuesen L, Smits PC, De Bruyne B, Koolen J, Windecker S, Whitbourn RJ, Meredith IT, Rapoza R, Garcia-Garcia HM, Ormiston JA, Serruys PW. TCT-593 In Vivo Assessment of the Bioresorption process of Everolimus-eluting PLLA Scaffold: a Light Intensity Analysis of Sequential Optical Coherence Tomography Imaging post Procedure, and at 1 and 3 Years in The ABSORB Cohort B2 Trial. J Am Coll Cardiol 2013. [DOI: 10.1016/j.jacc.2013.08.1340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Brener SJ, Dambrink JH, Maehara A, Chowdhary S, Gershlick AH, Genereux P, Koolen J, Mehran R, Fahy M, Gibson CM, Stone GW. Benefits of optimising coronary flow before stenting in primary percutaneous coronary intervention for ST-elevation myocardial infarction: insights from INFUSE-AMI. EUROINTERVENTION 2013:20130401-06. [PMID: 23764966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Aims: To determine the relation between thrombus aspiration (TA) and/or intra-lesion (IL) abciximab with pre-stent Thrombolysis in Myocardial Infarction (TIMI) flow grade and infarct size (IS) in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods and results: The INFUSE-AMI trial randomised 452 patients with anterior STEMI to IL abciximab vs. no abciximab, and to manual TA vs. no TA. The primary endpoint was cMRI-determined IS at 30 days. Patients were classified according to pre-stent TIMI flow. Complete data were available in 290 patients - 68 (25.2%) with pre-stent TIMI 0/1 flow, 47 (17.4%) with TIMI 2 flow and 175 (57.4%) with TIMI 3 flow. Patients with pre-stent TIMI 3 flow had significantly lower IS (15.5% [4.6, 21.8] vs. 22.6% [14.7, 28.0] for TIMI 2 vs. 19.5 [14.4, 27.8] for TIMI 0/1, p<0.0001) and fewer 30-day clinical events (p=0.03). Patients receiving TA with or without IL abciximab had the highest rate of pre-stent TIMI 3 flow (p<0.0001) and patients receiving both had the smallest IS (14.7% vs. 17.3% for the other three groups, p=0.03). Conclusions: Optimisation of coronary flow prior to stent implantation may reduce infarct size and clinical events in STEMI patients undergoing primary PCI.
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Brugaletta S, Gomez-Lara J, Bruining N, Radu MD, van Geuns RJ, Thuesen L, McClean D, Koolen J, Windecker S, Whitbourn R, Oberhauser J, Rapoza R, Ormiston JA, Garcia-Garcia HM, Serruys PW. Head to head comparison of optical coherence tomography, intravascular ultrasound echogenicity and virtual histology for the detection of changes in polymeric struts over time: insights from the ABSORB trial. EUROINTERVENTION 2013; 8:352-8. [PMID: 22130182 DOI: 10.4244/eijv8i3a54] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
AIMS To analyse and to compare the changes in the various optical coherence tomography (OCT), echogenicity and intravascular ultrasound virtual histology (VH) of the everolimus-eluting bioresorbable scaffold (ABSORB) degradation parameters during the first 12 months after ABSORB implantation. In the ABSORB study, changes in the appearance of the ABSORB scaffold were monitored over time using various intracoronary imaging modalities. The scaffold struts exhibited a progressive change in their black core area by OCT, in their ultrasound derived grey level intensity quantified by echogenicity, and in their backscattering ultrasound signal, identified as "pseudo dense-calcium" (DC) by VH. METHODS AND RESULTS From the ABSORB Cohort B trial 35 patients had paired OCT, echogenicity and VH assessment at baseline and at six- (n=18) or 12-months follow-up (n=17). Changes in OCT strut core area, hyperechogenicity and VH-derived DC were analysed and compared at the various time points. At six months, the change (median[IQR]) in OCT strut core area was -7.2% (-14.0-+0.9) (p=0.053), in hyperechogenicity -12.7% (-33.7-+1.4) (p=0.048) and VH-DC 22.1% (-10.8-+48.8) (p=0.102). At 12 months, all the imaging modalities showed a decrease in the various parameters considered (OCT: -12.2% [-17.5--1.9], p=0.093; hyperechogenicity -24.64% [-36.6--16.5], p=0.001; VH-DC: -24.66% [-32.0--7.0], p=0.071). However, the correlation between the relative changes in these parameters was statistically poor (Spearman's rho <0.4). CONCLUSIONS OCT, echogenicity and VH were able to detect changes in the ABSORB scaffold struts, although the correlation between those changes was poor. This is likely due to the fact that each imaging modality interrogates different material properties on different length scales. Further studies are needed to explore these hypotheses.
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Haude M, Erbel R, Erne P, Verheye S, Degen H, Böse D, Vermeersch P, Wijnbergen I, Weissman N, Prati F, Waksman R, Koolen J. Safety and performance of the drug-eluting absorbable metal scaffold (DREAMS) in patients with de-novo coronary lesions: 12 month results of the prospective, multicentre, first-in-man BIOSOLVE-I trial. Lancet 2013; 381:836-44. [PMID: 23332165 DOI: 10.1016/s0140-6736(12)61765-6] [Citation(s) in RCA: 226] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Bioabsorbable vascular scaffolds were developed to overcome limitations of permanent bare-metal or drug-eluting coronary stents—ie, stent thrombosis (despite prolonged dual antiplatelet therapy), the life-long presence of a caged vessel segment that does not allow vasomotion or remodelling, and chronic vessel wall inflammation. We assessed the safety and performance of a new magnesium-based paclitaxel-eluting absorbable metal scaffold in symptomatic patients with de-novo coronary lesions. METHODS We did a prospective, multicentre, first-in-man trial (BIOSOLVE-1) of the drug-eluting absorbable metal scaffold (DREAMS). 46 patients with 47 lesions were enrolled at five European centres. The primary endpoint was target lesion failure, a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularisation, at 6 and 12 months. Clinical follow-up was scheduled at 1, 6, 12, 24, and 36 months. Patients were consecutively assigned to angiographic and intravascular ultrasonographic follow-up at 6 months or 12 months. Optical coherence tomography was done in some patients. All patients were recommended to take dual antiplatelet therapy for at least 12 months. This trial is registered with ClinicalTrials.gov, number NCT01168830. FINDINGS Overall device and procedural success was 100%. Two of 46 (4%) patients had target lesion failure at 6 months (both clinically driven target lesion revascularisations), which rose to three of 43 (7%) at 12 months (one periprocedural target vessel myocardial infarction occurred during angiography at the 12 month follow-up visit). We noted no cardiac death or scaffold thrombosis. INTERPRETATION Our results show feasibility, a good safety profile, and promising clinical and angiographic performance results up to 12 months for DREAMS. Our promising clinical results show that absorbable metal scaffolds might be an alternative to polymeric absorbable scaffolds. FUNDING Biotronik.
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Affiliation(s)
- Michael Haude
- Medical Clinic I, Städtische Kliniken Neuss, Lukaskrankenhaus GmbH, Neuss, Germany.
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Gomez-Lara J, Diletti R, Brugaletta S, Onuma Y, Farooq V, Thuesen L, McClean D, Koolen J, Ormiston JA, Windecker S, Whitbourn R, Dudek D, Dorange C, Veldhof S, Rapoza R, Regar E, Garcia-Garcia HM, Serruys PW. Angiographic maximal luminal diameter and appropriate deployment of the everolimus-eluting bioresorbable vascular scaffold as assessed by optical coherence tomography: an ABSORB cohort B trial sub-study. EUROINTERVENTION 2012; 8:214-24. [PMID: 22030265 DOI: 10.4244/eijv8i2a35] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
AIMS Bioresorbable vascular scaffolds (BVS) present different mechanical properties as compared to metallic platform stents. Therefore, the standard procedural technique to achieve appropriate deployment may differ. METHODS AND RESULTS Fifty-two lesions treated with a 3 x 18 mm BVS were imaged with optical coherence tomography (OCT) post-implantation and screened for parameters suggesting non-optimal deployment. These included minimal scaffold area (minSA)<5 mm², residual area stenosis (RAS)>20%, edge dissections, incomplete scaffold/strut apposition (ISA)>5% and scaffold pattern irregularities. The angiographic proximal and distal maximal lumen diameters (DMAX) were measured by quantitative coronary angiography. Based on the DMAX values, the population was divided into three groups: DMAX <2.5 mm (n=13), DMAX between 2.5-3.3 mm (n=30) and DMAX >3.3 mm (n=9). All three groups presented with similar pre-implantation angiographic characteristics except for the vessel size and were treated with similar balloon/artery ratios. The group with a DMAX <2.5 mm presented with a higher percentage of lesions with minSA <5 mm² (30.8% vs. 10.0% vs. 0%; p=0.08) and edge dissections (61.5% vs. 33.3% vs. 11.1%; p=0.05). Lesions with >5% of ISA were significantly higher in the group with DMAX >3.3 mm (7.7% vs. 36.7% vs. 66.7%; p=0.02). RAS >20% was similar between all groups (46.2 vs. 53.3 vs. 77.8%; p=0.47) and scaffold pattern irregularities were only documented in three cases. CONCLUSIONS BVS implantation guided with quantitative angiography may improve the OCT findings of optimal deployment. The clinical significance of these angiographic and OCT findings warranted long term follow-up of larger cohort of patients.
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Diletti R, Farooq V, Girasis C, Bourantas C, Onuma Y, Heo JH, Gogas BD, van Geuns RJ, Regar E, de Bruyne B, Dudek D, Thuesen L, Chevalier B, McClean D, Windecker S, Whitbourn RJ, Smits P, Koolen J, Meredith I, Li X, Miquel-Hebert K, Veldhof S, Garcia-Garcia HM, Ormiston JA, Serruys PW. Clinical and intravascular imaging outcomes at 1 and 2 years after implantation of absorb everolimus eluting bioresorbable vascular scaffolds in small vessels. Late lumen enlargement: does bioresorption matter with small vessel size? Insight from the ABSORB cohort B trial. Heart 2012; 99:98-105. [PMID: 23118346 DOI: 10.1136/heartjnl-2012-302598] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The long-term results after second generation everolimus eluting bioresorbable vascular scaffold (Absorb BVS) placement in small vessels are unknown. Therefore, we investigated the impact of vessel size on long-term outcomes, after Absorb BVS implantation. METHODS In ABSORB Cohort B Trial, out of the total study population (101 patients), 45 patients were assigned to undergo 6-month and 2-year angiographic follow-up (Cohort B1) and 56 patients to have angiographic follow-up at 1-year (Cohort B2). The pre-reference vessel diameter (RVD) was <2.5 mm (small-vessel group) in 41 patients (41 lesions) and ≥2.5 mm (large-vessel group) in 60 patients (61 lesions). Outcomes were compared according to pre-RVD. RESULTS At 2-year angiographic follow-up no differences in late lumen loss (0.29±0.16 mm vs 0.25±0.22 mm, p=0.4391), and in-segment binary restenosis (5.3% vs 5.3% p=1.0000) were demonstrated between groups. In the small-vessel group, intravascular ultrasound analysis showed a significant increase in vessel area (12.25±3.47 mm(2) vs 13.09±3.38 mm(2) p=0.0015), scaffold area (5.76±0.96 mm(2) vs 6.41±1.30 mm(2) p=0.0008) and lumen area (5.71±0.98 mm(2) vs 6.20±1.27 mm(2) p=0.0155) between 6-months and 2-year follow-up. No differences in plaque composition were reported between groups at either time point. At 2-year clinical follow-up, no differences in ischaemia-driven major adverse cardiac events (7.3% vs 10.2%, p=0.7335), myocardial infarction (4.9% vs 1.7%, p=0.5662) or ischaemia-driven target lesion revascularisation (2.4% vs 8.5%, p=0.3962) were reported between small and large vessels. No deaths or scaffold thrombosis were observed. CONCLUSIONS Similar clinical and angiographic outcomes at 2-year follow-up were reported in small and large vessel groups. A significant late lumen enlargement and positive vessel remodelling were observed in small vessels.
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Affiliation(s)
- Roberto Diletti
- Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
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Ormiston JA, Serruys PW, Onuma Y, van Geuns RJ, de Bruyne B, Dudek D, Thuesen L, Smits PC, Chevalier B, McClean D, Koolen J, Windecker S, Whitbourn R, Meredith I, Dorange C, Veldhof S, Hebert KM, Rapoza R, Garcia-Garcia HM. First serial assessment at 6 months and 2 years of the second generation of absorb everolimus-eluting bioresorbable vascular scaffold: a multi-imaging modality study. Circ Cardiovasc Interv 2012; 5:620-32. [PMID: 23048057 DOI: 10.1161/circinterventions.112.971549] [Citation(s) in RCA: 169] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Nonserial observations have shown this bioresorbable scaffold to have no signs of area reduction at 6 months and recovery of vasomotion at 1 year. Serial observations at 6 months and 2 years have to confirm the absence of late restenosis or unfavorable imaging outcomes. METHODS AND RESULTS The ABSORB trial is a multicenter single-arm trial assessing the safety and performance of an everolimus-eluting bioresorbable vascular scaffold. Forty-five patients underwent serial invasive imaging, such as quantitative coronary angiography, intravascular ultrasound, and optical coherence tomography at 6 and 24 months of follow-up. From 6 to 24 months, late luminal loss increased from 0.16±0.18 to 0.27±0.20 mm on quantitative coronary angiography, with an increase in neointima of 0.68±0.43 mm(2) on optical coherence tomography and 0.17±0.26 mm(2) on intravascular ultrasound. Struts still recognizable on optical coherence tomography at 2 years showed 99% of neointimal coverage with optical and ultrasonic signs of bioresorption accompanied by increase in mean scaffold area compared with baseline (0.54±1.09 mm(2) on intravascular ultrasound, P=0.003 and 0.77±1.33 m(2) on optical coherence tomography, P=0.016). Two-year major adverse cardiac event rate was 6.8% without any scaffold thrombosis. CONCLUSIONS This serial analysis of the second generation of the everolimus-eluting bioresorbable vascular scaffold confirmed, at medium term, the safety and efficacy of the new device. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00856856.
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Dambrink JH, Brener S, Maehara A, Chowdhary S, Gershlick A, Koolen J, Mehran R, Fahy M, Gibson CM, Stone G. TCT-58 Effects of Mechanical Thrombectomy and Intracoronary Abciximab on Coronary Flow and Infarct Size During Primary PCI: Analysis from the INFUSE-AMI Trial. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gutiérrez-Chico JL, Wykrzykowska J, Koch K, Koolen J, Mario CD, Windecker S, Van Es GA, Juni P, Regar E, Serruys P. TCT-290 Vascular tissue reaction to acute malapposition in human coronary arteries: sequential assessment with optical coherence tomography. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Teeuwen K, Van den Branden B, Koolen J, Henriques J, Tijssen J, Kelder H, Van der Schaaf R, Vermeersch P, Rensing B, Suttorp MJ. TCT-440 Two-year Clinical Outcomes Of Primary Stenting Of Totally Occluded Native Coronary Arteries III (PRISON III): A Randomized Comparison Of Sirolimus-Eluting Stent Implantation With Zotarolimus-Eluting Stent Implantation For The Treatment Of Total Coronary Occlusions. J Am Coll Cardiol 2012. [DOI: 10.1016/j.jacc.2012.08.471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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