Clinical Research in Cardiology

, Volume 106, Issue 4, pp 271–279 | Cite as

Post-dilatation after implantation of bioresorbable everolimus- and novolimus-eluting scaffolds: an observational optical coherence tomography study of acute mechanical effects

  • Florian Blachutzik
  • Niklas Boeder
  • Jens Wiebe
  • Alessio Mattesini
  • Oliver Dörr
  • Astrid Most
  • Timm Bauer
  • Jens Röther
  • Monique Tröbs
  • Christian Schlundt
  • Stephan Achenbach
  • Christian W. Hamm
  • Holger M. Nef
Original Paper

Abstract

Objectives

The objective was to investigate the acute mechanical effects of post-dilatation on bioresorbable scaffolds (BRS) as determined by optical coherence tomography (OCT).

Background

Post-dilatation with high-pressure balloons is regarded as a key component of BRS implantation for treatment of coronary artery stenoses. However, the impact of post-dilatation on BRS in vivo has not been thoroughly investigated.

Methods

OCT was performed after the implantation procedure of 51 everolimus-eluting or novolimus-eluting polylactic acid-based BRS with (n = 27) or without non-compliant balloon post-dilatation (n = 24). The number of malapposed struts, strut fractures, edge dissections, residual in-scaffold area stenosis, and incomplete scaffold apposition area was analyzed over the complete length of each BRS with a spacing of 1 mm.

Results

OCT revealed a significantly lower incomplete scaffold apposition area if post-dilatation was performed (0.16 ± 0.49 mm2 with post-dilatation vs. 2.65 ± 2.78 mm2 without post-dilatation, p < 0.001), as well as a significantly lower absolute number of malapposed struts (1 ± 2 with post-dilatation vs. 13 ± 13 without post-dilatation, p < 0.001). No significant differences regarding residual in-scaffold area stenosis, strut fracture, edge dissection, symmetry index, or eccentricity index were observed in patients with vs. without post-dilatation.

Conclusion

Post-dilatation of BRS with non-compliant balloons significantly reduces the number of malapposed struts and incomplete scaffold apposition area without inducing higher rates of edge dissection or strut fracture.

Keywords

Bioresorbable vascular scaffolds Coronary artery disease Optical coherence tomography Percutaneous coronary intervention (PCI) 

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Florian Blachutzik
    • 1
  • Niklas Boeder
    • 2
  • Jens Wiebe
    • 3
  • Alessio Mattesini
    • 4
  • Oliver Dörr
    • 2
  • Astrid Most
    • 2
  • Timm Bauer
    • 2
  • Jens Röther
    • 1
  • Monique Tröbs
    • 1
  • Christian Schlundt
    • 1
  • Stephan Achenbach
    • 1
  • Christian W. Hamm
    • 2
  • Holger M. Nef
    • 2
  1. 1.Department of CardiologyFriedrich-Alexander University Erlangen-Nürnberg (FAU)ErlangenGermany
  2. 2.Department of Cardiology and AngiologyUniversity of GiessenGiessenGermany
  3. 3.Deutsches Herzzentrum München, Technische Universität MünchenMunichGermany
  4. 4.Department of Heart and VesselsAzienda Ospedaliero Universitaria CareggiFlorenceItaly

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