Patient profile and periprocedural outcomes of bioresorbable vascular scaffold implantation in comparison with drug-eluting and bare-metal stent implantation. Experience from ORPKI Polish National Registry 2014–2015

Abstract

IntroductionThere are limited data on the comparison of bioresorbable vascular scaffold (BVS) and drug-eluting stent (DES)/bare-metal stent (BMS) implantation in an unselected population of patients with coronary artery disease.AimTo compare the periprocedural outcomes and patient profile of BVS and DES/BMS implantation in an all-comer population from the ORPKI Polish National Registry.Material and methodsA total of 141,324 consecutive patients from 151 invasive cardiology centers in Poland were included in this prospective registry between January 2014 and June 2015. Periprocedural data on patients with at least one BVS (Absorb, Abbott Vascular, Santa Clara, CA, USA), DES or BMS (all available types) implantation in de novo lesions during index percutaneous coronary intervention for stable angina (SA) or acute coronary syndrome were collected.ResultsBioresorbable vascular scaffold was the most often used in patients with SA, in single-vessel disease and in younger male patients. Bioresorbable vascular scaffold implantation was significantly more often associated with periprocedural administration of ticagrelor/prasugrel (6.8% vs. 3.6%; p = 0.001) and use of intravascular ultrasound and optical coherence tomography in comparison with the DES/BMS group (2.8% vs. 0.6% and 1.8% vs. 0.1%, respectively; p = 0.001 for both). The incidence of periprocedural death was significantly lower in the BVS group than the DES/BMS group (0.04% vs. 0.32%; p = 0.02), but this difference was no longer significant after adjustment for covariates. On the other hand, coronary artery perforation occurred significantly more often during BVS delivery (0.31% vs. 0.12%; p = 0.01), and BVS implantation was identified as an independent predictor of coronary artery perforation in multivariate logistic regression analysis (OR = 6.728, 95% CI: 2.394–18.906; p = 0.001).ConclusionsPatients treated with BVS implantation presented an acceptable safety and efficacy profile in comparison with the DES/BMS group. However, lower risk patients were the most frequent candidates for BVS implantation.

Comparison of the Absorb bioresorbable vascular scaffold to the Xience durable polymer everolimus-eluting metallic stent in routine clinical practice: a propensity score-matched analysis from a multicenter registry

“…A higher prevalence of stable angina and lower rate of multi-vessel disease were also reported by Rzeszutko et al [ 11 ]. Similarly, the main periprocedural major adverse event was coronary artery perforation.…”

Two-year clinical outcomes after implantation of an everolimus-eluting bioresorbable scaffold (Absorb) in stable angina and acute coronary syndrome patients. Single-centre real-life registry data

“…Bioresorbable vascular scaffolds is relatively new in interventional cardiology. First generation BVS in simple de-novo lesions has been proven to be almost as good as DES with comparable MACE event rates (ABSORB, ABSORB II) and in all comer registries as in the retrospective registry GHOST-EU, the target lesion failure rate (TLF) at 1 year was very acceptable given the lesion and patient complexity; however, an increase in early ST was noted [ 10 , 11 ]. The ABSORB III trial demonstrated that the scaffold was non-inferior to the Xience stent with respect to target lesion failure at 1 year [ 12 ].…”

Predictors of in‐hospital effectiveness and complications of rotational atherectomy (from the ORPKI Polish National Registry 2014–2016)

“…Previously, published data from the ORPKI registry revealed an increased number of CAPs in patients with PCI and BVS in comparison to those with DES/BMS. This was explained by the preparation of the lesion for stent implantation . Previously published studies revealed that among predictors of in‐hospital MACE we may find peripheral artery disease, Dialysis, type C lesion and radial access .…”