A Comparison of the Conformability of Everolimus-Eluting Bioresorbable Vascular Scaffolds to Metal Platform Coronary Stents

Gomez‐Lara, Josep; García‐García, Héctor M.; Onuma, Yoshinobu; Garg, Scot; Regar, Evelyn; Bruyne, Bernard De; Windecker, Stefan; McClean, Dougal; Thuesen, Leif; Dudek, Dariusz; Koolen, Jacques; Whitbourn, Robert; Smits, Pieter C.; Chevalier, Bernard; Dorange, Cécile; Veldhof, Susan; Morel, Marie-Angèle; Vries, Ton de; Ormiston, John A.; Serruys, Patrick W.

doi:10.1016/j.jcin.2010.07.016

Cited by 96 publications

(76 citation statements)

References 28 publications

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“…By multivariate regression analysis, the independent predictors of changes in curvature and angulation were the pretreatment region curvature, the pre-treatment region angulation, and the used device. 18 At 6-or 12-month followup, the anatomical configuration of the arteries treated with the ABSORB BVS allowed restoration of coronary geometry to values close to those measured before implantation. 19 Late vascular remodeling in metallic stent and BVS One possible fate of the dilated but caged lesion is an intra-stent lumen reduction by intra-stent neointimal tissue growth (negative remodeling), even if the cytostatic drug slows down or postpones the phenomenon.…”

Section: Bvs and Vascular Geometrymentioning

confidence: 76%

“…This change in vessel biomechanics is also responsible for late strut fractures, that could lead to restenosis and clinical events. 17,18 After metallic stent implantation, the curvature of target vessel is increased by 121% at the entrance and by 100% at the exit of the stent, resulting in local changes in shear stress correlated with the local curvature. The initial superior conformability and flexibility of the ABSORB with respect to metallic stents can, at an early stage, contribute to less change in vessel geometry and biomechanics.…”

Section: Bvs and Vascular Geometrymentioning

confidence: 99%

“…The initial superior conformability and flexibility of the ABSORB with respect to metallic stents can, at an early stage, contribute to less change in vessel geometry and biomechanics. 18 A retrospective study compares 102 patients who received a metallic stent (Multi-link Vision or Xience V) in the SPIRIT FIRST and II trials with 89 patients treated with the ABSORB Revision 1.1 everolimus-eluting BVS from cohort B of the ABSORB trial. Both the metallic stent (MPS) and BVS groups had significant changes in relative region curvature (MPS vs.BVS: 28.7% vs. 7.5%) and angulation (MPS vs. BVS: 25.4% vs. 13.4%) after deployment.…”

Section: Bvs and Vascular Geometrymentioning

confidence: 99%

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Bioabsorbable Vascular Scaffold: A Revolution in Coronary Intervention

2014

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Since the advent of percutaneous coronary angioplasty in 1977, immense experiment has been done to improve the outcome of the patients with coronary artery disease. Lot of trials have been done with angioplasty, bare metal stents, drug eluting stents, drug eluting balloons and other devices. Bioabsorbable vascular stents are relatively newcomers in this field with a lot of hope. We tried to update the latest status of Bioabsorbable vascular stents in this review, specially the short and midterm safety and efficacy and some of their limitations. DOI: http://dx.doi.org/10.3329/cardio.v6i2.18359 Cardiovasc. j. 2014; 6(2): 149-163

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Section: Bvs and Vascular Geometrymentioning

confidence: 76%

Section: Bvs and Vascular Geometrymentioning

confidence: 99%

Section: Bvs and Vascular Geometrymentioning

confidence: 99%

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Bioabsorbable Vascular Scaffold: A Revolution in Coronary Intervention

2014

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“…14,15 Furthermore, as recently demonstrated in imaging studies including optical coherence tomography and virtual histology, plaque thinning, morphology changes, and vessel paving, 16,17 although intriguing, should translate into clinical utility when challenging the standard of care for permanent metallic stents.…”

Section: Will Brs Replace Metallic Stents?mentioning

confidence: 97%

The Disappearing Stent

Waksman

2012

Circulation

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“…The curvature value is calculated as 1/radius of the circle in cm −1 . "Angulation" is defined as the angle in degrees that the tip of an intracoronary guidewire would need to reach the distal part of a coronary bend (11).…”

Section: Curvature and Angulationmentioning

confidence: 99%

Methods to assess bioresorbable vascular scaffold devices behaviour after implantation

et al. 2017

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Bioresorbable vascular scaffolds (BRS) represent a novel approach for coronary revascularization offering several advantages as compared to current generation DES, potentially reducing rate of late adverse events and avoiding permanent vessel caging. Nevertheless, safety concerns have been raised for an increased risk of scaffold thrombosis (ScT) in both early and late phases, probably related to a suboptimal scaffold implantation. In this context, the use of different imaging methodologies has been strongly suggested in order to guarantee an optimal implantation. We herein analyze the different imaging methodologies available to assess BRS after implantation and at follow-up. J Thorac Dis 2017;9(Suppl 9):S959-S968 jtd.amegroups.com for BRS implantation in order to confirm optimal scaffold expansion, to exclude edge dissections, struts malapposition or underexpansion. Furthermore, imaging technique may evaluate at follow-up scaffold reabsorption and vessel changes over time. Keywords: Scaffold; intravascular ultrasound (IVUS); echogenicity; virtual histology-IVUS (VH-IVUS); optical coherence tomography (OCT); multislice coronary tomography (MSCT)SubmittedWe herein analyze the different imaging methodologies available to assess BRS after implantation and at follow-up. Quantitative coronary angiography (QCA)Coronary angiography is the most important method for assessing BRS implantation. As well as for conventional stent, at least two different projections with at least 30° difference for the right coronary artery and 3 different projections with at least 30° difference for the left coronary artery must be acquired before and after BRS implantation. The treated segment and the 5 mm proximal and distal to scaffold edges should be analyzed. As the bioresorbable devices are radiolucent, the QCA analysis may be performed visualizing the metallic markers of the scaffold.The following parameters can be measured. Acute recoilIt is defined as the difference between the mean diameter of the BRS delivery balloon (or, in case of post-dilatation, mean diameter of post-dilatation balloon) at the highest pressure and the mean lumen diameter (MLD) of the stented segment after balloon deflation. It can be expressed as absolute or relative value. The acute recoil is an important parameter in relation to the success of a PCI in acute and long-time period, as it has a direct impact on minimum stent area (MSA). A MSA less than 5.0 mm 2 is associated with high probability of in-stent restenosis (6).T h e a c u t e r e c o i l o f A b s o r b B V S 1 . 1 ( A b b o t t Laboratories, Abbott park, Illinois, USA) in the Absorb Cohort B trials and DESolve Nx BRS (Elixir Medical, Sunnyvale, California, USA) were 6.7%±6.4% and 6.4%±4.6%, respectively (7,8). These values are not dissimilar to those of metallic stent, showed in a Japanese study of 154 lesions comparing the biolimus eluting stent (Nobori stent, Terumo, Tokyo, Japan), cobalt chromium everolimus eluting stent (Xience V stent, Abbott Vascular, Santa Clara, CA, USA) and pl...

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A Comparison of the Conformability of Everolimus-Eluting Bioresorbable Vascular Scaffolds to Metal Platform Coronary Stents

Abstract: Bioresorbable vascular scaffolds have better conformability than conventional MPS. The clinical significance of the observed differences will require further investigation.

Cited by 96 publications

References 28 publications

Bioabsorbable Vascular Scaffold: A Revolution in Coronary Intervention

Bioabsorbable Vascular Scaffold: A Revolution in Coronary Intervention

The Disappearing Stent

Methods to assess bioresorbable vascular scaffold devices behaviour after implantation

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