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Neointimal coverage and late apposition of everolimus-eluting bioresorbable scaffolds implanted in the acute phase of myocardial infarction: OCT data from the PRAGUE-19 study

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Abstract

Incomplete stent apposition and uncovered struts are associated with a higher risk of stent thrombosis. No data exist on the process of neointimal coverage and late apposition status of the bioresorbable vascular scaffold (BVS) when implanted in the highly thrombogenic setting of ST-segment elevation acute myocardial infarction (STEMI). The aim of this study was to assess the serial changes in strut apposition and early neointimal coverage of the BVS using optical coherence tomography (OCT) in selected patients enrolled in the PRAGUE-19 study. Intracoronary OCT was performed in 50 patients at the end of primary percutaneous coronary intervention for acute STEMI. Repeated OCT of the implanted BVS was performed in 10 patients. Scaffold area, scaffold mean diameter and incomplete strut apposition (ISA) were compared between baseline and control OCT. Furthermore, strut neointimal coverage was assessed during the control OCT. Mean scaffold area and diameter did not change between the baseline and control OCT (8.59 vs. 9.06 mm2; p = 0.129 and 3.31 vs. 3.37 mm; p = 0.202, respectively). Differences were observed in ISA between the baseline and control OCT (0.63 vs. 1.47 %; p < 0.05). We observed 83.1 % covered struts in eight patients in whom the control OCT was performed 4–6 weeks after BVS implantation, and 100 % covered struts in two patients 6 months after BVS implantation. Persistent strut apposition and early neointimal coverage were observed after biodegradable vascular scaffold implantation in patients with acute ST-segment elevation myocardial infarction.

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Abbreviations

PCI:

Percutaneous coronary intervention

BVS:

Bioresorbable vascular scaffold

OCT:

Optical coherence tomography

STEMI:

ST-segment elevation myocardial infarction

ISA:

Incomplete strut apposition

References

  1. Ormiston J, Serruys PW, Onuma Y, van Geuns RJ, de Bruyne B, Dudek D, Thuesen L, Smits PC, Chevalier B, McClean D, Koolen J, Windecker S, Whitbourn R, Meredith I, Dorange C, Veldhof S, Hebert KM, Rapoza R, Garcia-Garcia HM (2012) First serial assessment at 6 months and 2 years of the second generation of absorb everolimus-eluting bioresorbable vascular scaffold: a multi-imaging modality study. Circ Cardiovasc Interv 5(5):620–632

    Article  CAS  PubMed  Google Scholar 

  2. Abizaid A, Costa JR, Bartorelli, Whitbourn R, van Geuns RJ, Chevalier B, Patel T, Seth A, Stuteville M, Dorange C, Cheong WF, Sudhir K, Serruys PW (2014) The ABSORB EXTEND study: preliminary report of the twelve-month clinical outcomes in the first 512 patients enrolled. EuroIntervention 2014 Apr 29. (Epub ahead of print)

  3. Serruys PW, Onuma Y, Garcia-Garcia HM, Muramatsu T, van Geuns RJ, de Bruyne B, Dudek D, Thuesen L, Smits PC, Chevalier B, McClean D, Koolen J, Windecker S, Whitbourn R, Meredith I, Dorange C, Veldhof S, Hebert KM, Rapoza R, Ormiston JA (2014) Dynamics of vessel wall changes following the implantation of the absorb everolimus-eluting bioresorbable vascular scaffold: a multi-imaging modality study at 6, 12, 24 and 36 months. EuroIntervention 9(11):1271–1284

    Article  PubMed  Google Scholar 

  4. Gomez-Lara J, Radu M, Brugaletta S, Farooq V, Diletti R, Onuma Y, Windecker S, Thuesen L, McClean D, Koolen J, Whitbourn R, Dudek D, Smits PC, Regar E, Veldhof S, Rapoza R, Ormiston JA, Garcia-Garcia HM, Serruys PW (2011) Serial analysis of the malapposed and uncovered struts of the new generation of everolimus-eluting bioresorbable scaffold with optical coherence tomography. JACC Cardiovasc Interv 4(9):992–1001

    Article  PubMed  Google Scholar 

  5. Serruys PW, Onuma Y, Ormiston JA, de Bruyne B, Regar E, Dudek D, Thuesen L, Smits PC, Chevalier B, McClean D, Koolen J, Windecker S, Whitbourn R, Meredith I, Dorange C, Veldhof S, Miquel-Hebert K, Rapoza R, García-García HM (2010) Evaluation of the second generation of a bioresorbable everolimus drug-eluting vascular scaffold for treatment of de novo coronary artery stenosis: 6-month clinical and imaging outcomes. Circulation 122(22):2301–2312

    Article  CAS  PubMed  Google Scholar 

  6. Kajiya T, Liang M, Sharma RK, Lee CH, Chan MY, Tay E, Chan KH, Tan HC, Low AF (2013) Everolimus-eluting bioresorbable vascular scaffold (BVS) implantation in patients with ST-segment elevation myocardial infarction (STEMI). EuroIntervention 9(4):501–504

    Article  PubMed  Google Scholar 

  7. Diletti R, Karanasos A, Muramatsu T, Nakatani S, Van Mieghem NM, Onuma Y, Nauta ST, Ishibashi Y, Lenzen MJ, Ligthart J, Schultz C, Regar E, de Jaegere PP, Serruys PW, Zijlstra F, van Geuns RJ (2014) Everolimus-eluting bioresorbable vascular scaffolds for treatment of patients presenting with ST-segment elevation myocardial infarction: BVS STEMI first study. Eur Heart J 35(12):777–786

    Article  CAS  PubMed  Google Scholar 

  8. Gori T, Schulz E, Hink U, Wenzel P, Post F, Jabs A, Münzel T (2014) Early outcome after implantation of Absorb bioresorbable drug-eluting scaffolds in patients with acute coronary syndromes. EuroIntervention 9(9):1036–1041

    Article  PubMed  Google Scholar 

  9. Kocka V, Maly M, Tousek P, Buděšínský T, Lisa L, Prodanov P, Jarkovský J, Widimský P (2014) Bioresorbable vascular scaffolds in acute ST-segment elevation myocardial infarction: a prospective multicentre study ‘Prague 19’. Eur Heart J 35(12):787–794

    Article  PubMed  PubMed Central  Google Scholar 

  10. Barbato E, Wijns W (2014) Bioresorbable coronary scaffolds: a novel device-based solution in search of its clinical need. Eur Heart J 35(12):753–757

    Article  PubMed  Google Scholar 

  11. Mrdovic I, Savic L, Lasica R, Krljanac G, Asanin M, Brdar N, Djuricic N, Cvetinovic N, Marinkovic J, Perunicic J (2013) Usefulness of the RISK-PCI score to predict stent thrombosis in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a substudy of the RISK-PCI trial. Heart Vessels 28(4):424–433

    Article  PubMed  Google Scholar 

  12. Attizzani GF, Capodanno D, Ohno Y, Tamburino C (2014) Mechanisms, pathophysiology, and clinical aspects of incomplete stent apposition. J Am Coll Cardiol 63(14):1355–1367

    Article  PubMed  Google Scholar 

  13. Gomez-Lara J, Brugaletta S, Farooq V, Onuma Y, Diletti R, Windecker S, Thuesen L, McClean D, Koolen J, Whitbourn R, Dudek D, Smits PC, Chevalier B, Regar E, Veldhof S, Rapoza R, Ormiston JA, Garcia-Garcia HM, Serruys PW (2011) Head-to-head comparison of the neointimal response between metallic and bioresorbable everolimus-eluting scaffolds using optical coherence tomography. JACC Cardiovasc Interv 4(12):1271–1280

    Article  PubMed  Google Scholar 

  14. Li S, Wang Y, Gai L, Yang T, Liu H, Wang Z, Bai Q, Xu X, Chen Y (2011) Evaluation of neointimal coverage and apposition with various drug-eluting stents over 12 months after implantation by optical coherence tomography. Int J Cardiol 162(3):166–171

    Article  PubMed  Google Scholar 

  15. Ikuta S, Kobuke K, Iwanaga Y, Nakauchi Y, Yamaji K, Miyazaki S (2014) Difference in neointimal coverage at chronic stage between bare metal stent and sirolimus-eluting stent evaluated at stent-strut level by optical coherence tomography. Heart Vessels 29(3):320–327

    Article  PubMed  Google Scholar 

  16. Ormiston JA, De Vroey F, Serruys PW, Webster MW (2011) Bioresorbable polymeric vascular scaffolds: a cautionary tale. Circ Cardiovasc Interv 4(5):535–538

    Article  PubMed  Google Scholar 

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Acknowledgments

This study was supported by the Charles University Research programs P35 and UNCE 204010.

Conflict of interest

V. K. and P. W. received occasional speaker honoraria from Abbott Vascular. Other authors have no conflicts of interests to declare.

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Authors and Affiliations

  1. Third Faculty of Medicine, Cardiocenter, Charles University in Prague, University Hospital Kralovske Vinohrady, Ruska 87, 100 00, Prague, Czech Republic

    Petr Toušek, Viktor Kočka, Libor Lisa, Tomáš Buděšínský & Petr Widimský

  2. First Faculty of Medicine, Cardiovascular Center, Charles University in Prague, Central Military Hospital Prague, Prague, Czech Republic

    Martin Malý

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  1. Petr Toušek
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  2. Viktor Kočka
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  3. Martin Malý
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Correspondence to Viktor Kočka.

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Toušek, P., Kočka, V., Malý, M. et al. Neointimal coverage and late apposition of everolimus-eluting bioresorbable scaffolds implanted in the acute phase of myocardial infarction: OCT data from the PRAGUE-19 study. Heart Vessels 31, 841–845 (2016). https://doi.org/10.1007/s00380-015-0679-8

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  • DOI: https://doi.org/10.1007/s00380-015-0679-8

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