Back to Search
Start Over
Clinical, Angiographic, and Procedural Correlates of Very Late Absorb Scaffold Thrombosis
- Source :
- JACC: Cardiovascular Interventions. 11:638-644
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Objectives The aim of this study was to identify independent correlates of very late scaffold thrombosis (VLST) from an analysis of consecutively treated patients from 15 multicenter studies. Background Recent analyses suggest an increased risk for VLST with the Absorb Bioresorbable Vascular Scaffold compared with drug-eluting stents, but insights as to correlates of risk are limited. Methods A total of 55 patients were identified with scaffold thrombosis. They were matched 2:1 with control subjects selected randomly from patients without thrombosis from the same study. Quantitative coronary angiography was available for 96.4% of patients. Multiple logistic and Cox regression analysis were used to identify significant independent outcome correlates from 6 pre-specified characteristics. Results Patients had scaffold thrombosis at a median of 20 months (interquartile range: 17 to 27 months). Control subjects were followed for 36 months (interquartile range: 24 to 38 months). For the combined groups, reference vessel diameter (RVD) was 2.84 ± 0.50 mm, scaffold length was 26 ± 16 mm, and post-dilatation was performed in 56%. Univariate correlates of thrombosis were smaller nominal scaffold/RVD ratio (linear p = 0.001; ratio 2.72 mm; odds ratio: 3.4; p = 0.001). Post-dilatation at ≥16 atm, post-dilatation balloon/scaffold ratio, final percentage stenosis, and dual antiplatelet therapy were not correlated with VLST. Only scaffold/RVD ratio remained a significant independent correlate of VLST (p = 0.001), as smaller ratio was correlated with RVD (p Conclusions In the present analysis, the largest to date of its type, relative scaffold undersizing was the strongest determinant of VLST. Given current understanding of “scaffold dismantling,” this finding likely has ramifications for all bioresorbable scaffolds.
- Subjects :
- medicine.medical_specialty
Scaffold
Proportional hazards model
business.industry
Odds ratio
030204 cardiovascular system & hematology
Balloon
medicine.disease
Thrombosis
03 medical and health sciences
Stenosis
0302 clinical medicine
Interquartile range
Internal medicine
medicine
Cardiology
030212 general & internal medicine
Cardiology and Cardiovascular Medicine
business
Bioresorbable vascular scaffold
Subjects
Details
- ISSN :
- 19368798
- Volume :
- 11
- Database :
- OpenAIRE
- Journal :
- JACC: Cardiovascular Interventions
- Accession number :
- edsair.doi...........0042f837fb80ed96933371afd37ee330
- Full Text :
- https://doi.org/10.1016/j.jcin.2017.11.042