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Overlapping implantation of bioresorbable novolimus-eluting scaffolds: an observational optical coherence tomography study

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Abstract

Overlapping implantation of bioresorbable vascular scaffolds is frequently necessary, but its influence on vessel and scaffold structure has not been thoroughly analyzed previously. The aim of this study was to analyze the acute effects of overlapping implantation on BRS as determined by optical coherence tomography (OCT). A total of 38 patients with de novo coronary artery stenoses who underwent OCT in the context of implantation of novolimus-eluting BRS (DESolve, Elixir Medical Corporation, Sunnyvale, California, USA) were investigated. In 15 patients, overlapping implantation of two BRS was performed, while 23 patients with implantation of one single BRS served as the control group. OCT data were retrospectively analyzed regarding acute scaffold implantation results. There were no significant differences between the overlap and control group in terms of residual in-scaffold area stenosis, scaffold area, mean or minimal lumen area, eccentricity index, incomplete scaffold apposition area or malapposition. While strut fracture was slightly more frequent in BRS with overlap its incidence was low overall. In patients with overlapping BRS, overlap segments did not display smaller lumen areas than segments without overlap (mean lumen area overlap: 8.16 ± 2.97 mm2 vs. no overlap: 7.70 ± 2.55 mm2; p = 0.71; minimal lumen area overlap: 6.83 ± 2.71 mm2 vs. no overlap: 6.17 ± 2.58 mm2; p = 0.37). Acute mechanical performance of novolimus-eluting BRS is not impaired by overlapping implantation. It can be assumed that vessel expansion compensates for the double scaffold layer in the overlap area resulting in a similar lumen area in overlap areas and in those with a single strut layer.

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    Authors and Affiliations

    1. Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Department of Medicine 2-Cardiology, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany

      Florian Blachutzik, Monique Tröbs, Jens Röther, Christian Schlundt & Stephan Achenbach

    2. Justus Liebig Universität Giessen, University Hospital Giessen, Medical Clinic I, Giessen, Germany

      Niklas Boeder, Oliver Dörr, Astrid Most, Timm Bauer, Christian Hamm & Holger Nef

    3. German Heart Centre Munich, Munich, Germany

      Jens Wiebe

    4. Careggi Hospital, Florence, Italy

      Alessio Mattesini

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    1. Florian Blachutzik
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    2. Niklas Boeder
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    Correspondence to Florian Blachutzik.

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    Conflict of interest

    Holger Nef received speaking honoraria and a research grant (to institution) from Elixir Medical. All other authors have no potential conflict of interest. There are no relationships with industry regarding this study.

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    F. Blachutzik and N. Boeder contributed equally.

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    Blachutzik, F., Boeder, N., Wiebe, J. et al. Overlapping implantation of bioresorbable novolimus-eluting scaffolds: an observational optical coherence tomography study. Heart Vessels 32, 781–789 (2017). https://doi.org/10.1007/s00380-016-0932-9

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    • DOI: https://doi.org/10.1007/s00380-016-0932-9

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