CTA Evaluation of Bioresorbable Scaffolds versus Metallic Coronary Stents – a Feasibility Study

Ferenţ, Ionuţ; Mester, András; Chițu, Monica; Benedek, Annabell; Raţiu, Mihaela; Hodaş, Roxana; Benedek, Imre

doi:10.2478/jim-2018-0033

Cited by 3 publications

(3 citation statements)

References 24 publications

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“…Since coronary stenosis alone does not predict the risk of future cardiovascular events, the coronary artery calcium (CAC) score estimates the overall calcification burden and predicts future ischemic events without contrast use. With the introduction of bioresorbable stents (Figures 4 and 5 ), this set-back has been overcome[ 145 , 146 ]. Contrary to magnetic resonance imaging (MRI), pacemakers and defibrillators do not preclude the use of CCTA, however it should be noted that their leads may create artefacts.…”

Section: Coronary Computed Tomography Angiographymentioning

confidence: 99%

Stent visualization methods to guide percutaneous coronary interventions and assess long-term patency

Ghafari¹,

Carlier²

2021

WJC

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Evaluation of acute percutaneous coronary intervention (PCI) results and long-term follow-up remains challenging with ongoing stent designs. Several imaging tools have been developed to assess native vessel atherosclerosis and stent expansion, improving overall PCI results and reducing adverse cardiac events. Quantitative coronary analysis has played a crucial role in quantifying the extent of coronary artery disease and stent results. Digital stent enhancement methods have been well validated and improved stent strut visualization. Intravascular imaging remains the gold standard in PCI guidance but adds costs and time to the procedure. With a recent shift towards non-invasive imaging assessment and coronary computed tomography angiography imaging have shown promising results. We hereby review novel stent visualization techniques used to guide PCI and assess stent patency in the modern PCI era.

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Section: Coronary Computed Tomography Angiographymentioning

confidence: 99%

Stent visualization methods to guide percutaneous coronary interventions and assess long-term patency

Ghafari¹,

Carlier²

2021

WJC

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“…Furthermore, the workgroup analyzed plaque composition and demonstrated a significant decrease of the fibro-fatty tissue after BVS implantation (10.31% ± 6.24 vs. 6.46% ± 6.14, p = 0.01) and regression of the vulnerability degree of coronary plaques (with significant decrease of low attenuation plaques [37.5% vs. 20.83%, p = 0.01] and significant increase of spotty calcifications after BVS implantation [66.66% vs. 79.16%, p = 0.05]). 16,17 The result of this study aids in the understanding of vascular and plaque changes following BVS implantation and further enhances the role of CCTA in the evaluation of BVS. The authors succeeded to make a big step forward in order to validate CCTA as the method of choice for imaging-based follow-up of patients with BVS.…”

Section: Noninvasive Imaging Methodsmentioning

confidence: 81%

Imaging Bioresorbable Vascular Scaffolds – at the Border between Science and Technology

Mester

2018

Journal of Interdisciplinary Medicine

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PERcuTAnEOus cOROnARy REvAscuLARIzATIOn -fROm bALLOOn TO bIOREsORbAbLE scAffOLDsCoronary artery disease (CAD), in its various forms of clinical presentations, including acute coronary syndromes and stable CAD, continues to negatively impact the quality of life, mortality and morbidity, while concomitantly increasing healthcare costs. As the number of patients with CAD increases, the need for optimal revascularization strategies rises, both in the area of interventional cardiology and in coronary artery by-pass grafting techniques, which have substantially developed during the last decades. 1 Percutaneous coronary revascularization techniques have undergone considerable progress in the last four decades, from the first use of balloon angioplasty, which provided a mechanical vascular patency but with a high risk of early recoil, to the introduction of the first metal stents that were able to provide better long-term results compared to balloon dilation. In spite of this, bare metal stents presented several disadvantages, including high rates of in-stent restenosis, therefore a need for an upgrade emerged that led to the development of drugeluting stents (DES). The main advantage of DES consisted in being coated with anti-proliferative pharmacological agents that inhibit neointimal proliferation, thus preventing restenosis. However, there were major concerns regarding the increased risk of late in-stent thrombosis which was higher in DES, meaning longer dual-antiplatelet therapy regimens, with their associated adverse effects. [2][3][4][5] Newer-generation DES have been shown to present lower rates of late and very late thrombosis if associated with prolonged double-antiplatelet therapies. Their remaining main disadvantages include the failure to restore the native vascular motricity, architecture, and physiological function due to implantation of a rigid metallic cage-like structure at the site of the coronary lesion. 6 The development of bioresorbable vascular scaffolds (BVS) has revolutionized percutaneous coronary revascularization procedures, as they provide proper radial support CORRESPONDENCE András Mester Str. Gheorghe Marinescu nr. 38

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“…Advances in CCTA technology allow better luminal evaluation as well as plaque characterization, with contemporary studies showing high sensitivity and specificity to exclude obstructive lesions [ 35 , 36 , 37 ]. Moreover, the polymeric scaffold of BRS does not produce beam-hardening artifacts, hence minimizing the blooming effect and allowing CCTA to have higher diagnostic accuracy to detect in-scaffold lumen obstruction [ 38 , 39 , 40 ].…”

Section: Discussionmentioning

confidence: 99%

Bioresorbable Magnesium-Based Stent: Real-World Clinical Experience and Feasibility of Follow-Up by Coronary Computed Tomography: A New Window to Look at New Scaffolds

et al. 2023

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(1) Background: The diagnostic accuracy of coronary computed tomography angiography (CCTA) for coronary artery disease (CAD) has greatly improved so CCTA represents a transition in the care of patients suffering from CAD. Magnesium-based bioresorbable stents (Mg-BRS) secure acute percutaneous coronary intervention (PCI) results without leaving, in the long term, a metallic caging effect. The purpose of this real-world study was to assess clinical and CCTA medium- and long-term follow-up of all our patients with implanted Mg-BRS. (2) Methods: The patency of 52 Mg-BRS implanted in 44 patients with de novo lesions (24 of which had acute coronary syndrome (ACS)) was evaluated by CCTA and compared to quantitative coronary angiography (QCA) post-implantation. (3) Results: ten events including four deaths occurred during a median follow-up of 48 months. CCTA was interpretable and in-stent measurements were successful at follow-up without being hindered by the stent strut’s “blooming effect”. Minimal in-stent diameters on CCTA were found to be 1.03 ± 0.60 mm smaller than the expected diameter after post-dilation on implantation (p < 0.05), a difference not found in comparing CCTA and QCA. (4) Conclusions: CCTA follow-up of implanted Mg-BRS is fully interpretable and we confirm the long-term Mg-BRS safety profile.

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CTA Evaluation of Bioresorbable Scaffolds versus Metallic Coronary Stents – a Feasibility Study

Cited by 3 publications

References 24 publications

Stent visualization methods to guide percutaneous coronary interventions and assess long-term patency

Stent visualization methods to guide percutaneous coronary interventions and assess long-term patency

Imaging Bioresorbable Vascular Scaffolds – at the Border between Science and Technology

Bioresorbable Magnesium-Based Stent: Real-World Clinical Experience and Feasibility of Follow-Up by Coronary Computed Tomography: A New Window to Look at New Scaffolds

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