Aim: In this study, acute coronary syndrome and angina patients with everolimus-eluting bioresorbable scaffold implant were assessed for the angiographic and clinical outcomes at four years. 

Methods: About 379 patients, of which 190 were males and 189 were females, who had undergone bioresorbable scaffold implantation followed by the percutaneous coronary intervention (PCI) were part of the study. The mean age of the group was 56 ± 11.2 years. 

Clinical outcomes such as repeated PCI, target vessel revascularization, cerebral infarction, target lesion revascularization, scaffold thrombosis, myocardial death, cardiovascular death, and all-cause death were analyzed at four years.

Clinical characteristics:

  • Arterial hypertension: 319 (84.2%)

  • Diabetes mellitus: 60 (12.9%)

  • Dyslipidemia: 303 (79.9%) 

  • Previous myocardial infarction: 120 (31.7%)

  • Previous PCI: 171 (45.1%)

  • Stable angina: 292 (77%)

  • Multivessel disease: 245 (64.6%)

Only 5 (1.3%) participants had a previous coronary artery bypass grafting, and 7 (1.8%) encountered silent ischemia. STEMI was seen in 31 (8.2%) and NSTEMI in 23 (6.1%) patients.

Angiographic features: 

  • Intravascular ultrasound: 48 (12.7%)

  • Femoral approach: 86 (22.7%)

  • Optical coherence tomography 38 (10%)

  • GPIIb/IIIa blockers during index PCI 206 (54.4%)

Majority of the subjects, around 293 (77.3%) had a radial approach to angiography.

Pre-dilatation: 

  • Regular balloon: 134 (35.4%)

  • Cutting balloon: 211 (55.7%)

The mean diameter and length of the pre-dilatation balloon were 15 ± 7.80 mm and 3 ± 0.35mm. Mean device length and diameter were 18 ± 7.73 mm and 3 ± 0.35 mm.

The mean post-dilatation balloon diameter was 3.50 ± 0.38 mm.

352 participants were tracked at the 4-year follow-up.

Out of the 379 participants, hospital myocardial infarction occurred in 2, and hospital device thrombosis occurred in 1 case.

The deaths were noted as:

  • Cardiovascular death: 8 out of 376

  • All reason death: 22 out of 376

  • Hospital death: 2 out of 379

For n= 371:

  • Minor bleeding: 5 (1.3%)

  • Cerebral infarction:4 (1.2%)

  • Target vessel revascularization: 45 (11.9%)

  • Target lesion revascularization: 23 (6.1%)

  • CABG: 2 (0.5%)

  • Myocardial infarction: 18 (4.8%)

Device thrombosis was seen in 5 out of 371 subjects. 3 of them discontinued DAPT.

Conclusion: The study concluded that in various coronary pathologies like acute coronary syndrome, multivessel disease bioresorbable scaffolds could be used safely and effectively.

 

Source

https://eposter.europa-organisation.com/2021/europcr/index/slide/abstract/33#