Neoatherosclerosis 5 Years After Bioresorbable Vascular Scaffold Implantation

Neoatherosclerosis ― Long-Term Assessment of Bioresorbable Vascular Scaffold ―

“…Data regarding neoatherosclerosis after Absorb BVS implantation are still very limited (Table). 7,[26][27][28][29][30][31][32] To the best of our knowledge, our previous study first and comprehensively described the incidence of neoatherosclerosis at 5 years following Absorb BVS rev.1.1 implantation on serial imaging. 7 Neoatherosclerosis was more prevalent at 5 years than at 1 year (1 year vs. 5 years, Figure 2.…”

“…In terms of 5-year assessment, two reports investigated vasomotor response after NTG injection. 7,40 Dudek et al confirmed a numerical increase in vasomotor response to NTG from 2 to 5 years after Absorb BVS on quantitative coronary angiography (QCA) according to mean lumen diameter (mean inscaffold lumen diameter: 2 years, 0.03±0.09 mm; 3 years, 0.05±0.12 mm; 5 years, 0.07±0.08 mm, P=0.40). The degree of vasomotor response in the in-scaffold segment, however, was lower compared with the adjacent segments, 40 and our data also support this: we confirmed that a significantly smaller change was observed for the in-scaffold than for the out-scaffold segment after NTG injection at 5 years after Absorb BVS implantation on QCA according to mean lumen diameter (∆ in-scaffold, +0.009±0.012 mm vs. ∆ out-scaffold, +0.14±0.14 mm, P<0.01), which could further support the existence of neoatherosclerosis.…”

“…MORIYAMA N et al Figure 3). 7 A previous study reported on the time course of neoatherosclerosis after DES implantation. 36 At 48-month followup, 75% of all lesions with 50% diameter stenosis had lipid plaque and neovascularization.…”

Current perspectives on the role of bioresorbable scaffolds in the management of coronary artery disease

“…Also, specifically for BRS technologies, the loss of integrity of the scaffold backbone as a result of bioresorption may lead to prolapse of part of the scaffold into the vessel lumen and possible disturbances of coronary blood flow [12,[32][33][34]37]. In addition, a recent substudy of the ABSORB EXTEND trial has suggested the occurrence and progression of in-scaffold neoatherosclerosis with luminal narrowing five years after Absorb scaffold implantation [38].…”

Case Report: Case of Coronary Stent Longitudinal Deformation

“…[4][5][6] In post cardiopulmonary resuscitation 7 cases, there are case reports that showed complications such as distortion, compression, dislodgement, and migration of large endovascular stents. Multiple trials have showed that increased rate of stent deformation result in stent thrombosis with bioabsorbable polymeric scaffolds (BRS) 8,9 and it may be explained by malapposition from weak polymer materials in BRS and result in asymmetric material degradation from microstructural damage due to local stress concentration from the stent crimping, which is less often reported in stents with nonabsorbable polymeric scaffolds. However, there are limited reports of migration and dislodgement of a DES shortly after its deployment.…”