Search

Objectives The purpose of this study was to compare the 1-year outcome of everolimus-eluting bioresorbable scaffolds (eBRS) and Novolimus-eluting bioresorbable scaffolds (nBRS) in patients undergoing percutaneous coronary intervention in a real-life clinical practice scenario. Background eBRS and nBRS are available and have been proved safe for coronary artery stenting in well-selected patients. Methods Consecutive patients who underwent bioresorbable scaffold implantation were evaluated retrospectively via 2:1 propensity matching. Target lesion failure comprising cardiac death, target vessel myocardial infarction, and target lesion revascularization was examined after 12 months, along with its individual components as well as scaffold thrombosis. Results A total 506 patients were available for matching. Of these, 212 eBRS patients (mean age = 62.9 years) and 106 nBRS patients (mean age = 63.1 years) were analyzed after matching. Baseline characteristics and clinical presentation were comparable in both groups. Acute coronary syndromes were present in 53.3% of the eBRS group and in 48.1% of the nBRS group (p = 0.383). Lesion characteristics were also similar. Pre-dilation (99.5% vs. 98.1%; p = 0.218) and post-dilation (84.4% vs. 86.8%; p = 0.576) were performed in the same proportion of matched eBRS and nBRS patients, respectively. The 1-year rates of target lesion failure (4.7% vs. 4.5%; p = 0.851), target lesion revascularization (2.6% vs. 3.5%; p = 0.768), cardiac death (1.5% vs. 2.0%; p = 0.752), and definite scaffold thrombosis (2.0% vs. 1.0%; p = 0.529) did not differ significantly between the eBRS and nBRS groups. Conclusions The present study reveals comparable clinical results for the 2 types of bioresorbable scaffolds when used during routine practice, but further evidence from randomized controlled trials is needed.

Resumen Introduccion y objetivos El implante de armazones bioabsorbibles (AB) es una tecnica emergente que se utiliza en las intervenciones coronarias percutaneas. Su aplicacion se ha extendido a las lesiones mas complejas, aunque solo se dispone de evidencia respecto a las lesiones simples. En el presente estudio se evaluo el implante del AB en lesiones largas atendiendo al solapamiento de los AB. Metodos Se llevo a cabo un analisis retrospectivo de todos los pacientes consecutivos considerados aptos para el implante de un AB de acido poli-L-lactico liberador de everolimus con una longitud total minima de 28 mm, con independencia del numero de AB implantados. Los objetivos principales fueron los eventos adversos cardiacos mayores (que incluyen la muerte cardiaca, cualquier infarto de miocardio y la revascularizacion de la lesion diana) y el fallo de la lesion diana (que incluye la muerte cardiaca, el infarto de miocardio del vaso diana y la revascularizacion de la lesion diana). Se realizo un analisis de subgrupos para la evaluacion de los pacientes con AB solapados. Resultados Se incluyo en total a 250 pacientes. El motivo de la angiografia fue enfermedad coronaria estable en el 36,4% de los pacientes (91 de 250), un sindrome coronario agudo en el 61,6% (154 de 250) y otros en el 2,0% (5 de 250). Se alcanzo exito de la intervencion en el 97,8% (267 de 273) de las lesiones. En el seguimiento de 12 meses, las tasas de eventos cardiacos adversos mayores, fallos de la lesion diana y trombosis del armazon fueron del 8,5, el 6,6 y el 2,3% respectivamente. El analisis del subgrupo de 239 pacientes puso de manifiesto que no habia diferencias estadisticamente significativas entre los pacientes con y sin solapamiento de AB despues de un seguimiento de 12 meses. Conclusiones El implante de stents en segmentos largos empleando un solo armazon o multiples armazones solapados es factible tecnicamente, y los resultados a medio plazo son adecuados. Sin embargo, seran necesarios estudios aleatorizados a gran escala para confirmar la prueba de concepto.

The purpose of this study was to compare the 1-year outcome of everolimus-eluting bioresorbable scaffolds (eBRS) and Novolimus-eluting bioresorbable scaffolds (nBRS) in patients undergoing percutaneous coronary intervention in a real-life clinical practice scenario.eBRS and nBRS are available and have been proved safe for coronary artery stenting in well-selected patients.Consecutive patients who underwent bioresorbable scaffold implantation were evaluated retrospectively via 2:1 propensity matching. Target lesion failure comprising cardiac death, target vessel myocardial infarction, and target lesion revascularization was examined after 12 months, along with its individual components as well as scaffold thrombosis.A total 506 patients were available for matching. Of these, 212 eBRS patients (mean age = 62.9 years) and 106 nBRS patients (mean age = 63.1 years) were analyzed after matching. Baseline characteristics and clinical presentation were comparable in both groups. Acute coronary syndromes were present in 53.3% of the eBRS group and in 48.1% of the nBRS group (p = 0.383). Lesion characteristics were also similar. Pre-dilation (99.5% vs. 98.1%; p = 0.218) and post-dilation (84.4% vs. 86.8%; p = 0.576) were performed in the same proportion of matched eBRS and nBRS patients, respectively. The 1-year rates of target lesion failure (4.7% vs. 4.5%; p = 0.851), target lesion revascularization (2.6% vs. 3.5%; p = 0.768), cardiac death (1.5% vs. 2.0%; p = 0.752), and definite scaffold thrombosis (2.0% vs. 1.0%; p = 0.529) did not differ significantly between the eBRS and nBRS groups.The present study reveals comparable clinical results for the 2 types of bioresorbable scaffolds when used during routine practice, but further evidence from randomized controlled trials is needed.

Introduction and objectives The implantation of bioresorbable scaffolds (BRS) is an emerging technique used in percutaneous coronary interventions. Their application has been extended to more complex lesions, although evidence is only available for simple lesions. The present study evaluated scaffold implantation in long lesions, focusing on overlapping scaffolds. Methods We retrospectively analyzed all consecutive patients eligible for stenting with everolimus-eluting poly-L-lactic acid-based BRS with a minimum total scaffold length of 28 mm, irrespective of the number of BRS used. The main target parameters were major adverse cardiac events, comprising cardiac death, any myocardial infarction, and target lesion revascularization, and target lesion failure, including cardiac death, target vessel myocardial infarction, and target lesion revascularization. A subgroup analysis included patients with overlapping BRS. Results A total of 250 patients were included. The reason for angiography was stable coronary artery disease in 36.4% (91 of 250), an acute coronary syndrome in 61.6% (154 of 250), and other reasons in 2.0% (5 of 250). Procedural success was achieved in 97.8% (267 of 273) of the lesions. During follow-up, the 12-month rates of major adverse cardiac event, target lesion failure, and scaffold thrombosis were 8.5%, 6.6%, and 2.3%, respectively. Subgroup analysis of 239 patients showed that there were no statistically relevant differences between patients with and without overlapping scaffolds after a 12-month follow-up. Conclusions Long-segment stenting with a single scaffold or with multiple overlapping scaffolds is technically feasible with adequate mid-term outcomes. However, large-scale randomized studies are needed to provide further proof of concept.