Author + information
- Kyohei Yamaji1,
- Lorenz Raber1,
- Salvatore Brugaletta2,
- Andres Iñiguez3,
- Lisette Okkels Jensen4,
- Angel Cequier5,
- Sjoerd H. Hofma6,
- Evald Christiansen7,
- Maarten Suttorp8,
- Gerrit-Anne Van Es9,
- Yohei Sotomi10,
- Yoshinobu Onuma11,
- Manel Sabate2,
- Patrick Serruys12 and
- Stephan Windecker1
- 1University Hospital Bern, Bern, Switzerland
- 2Hospital Clínic, University of Barcelona, Barcelona, Spain
- 3Complejo Hospitalario Universitario de Vigo, Vigo, Spain
- 4Odense University Hospital, Odense, Denmark
- 5Bellvitge University Hospital, Barcelona, Spain
- 6Medical Center Leeuwarden, Leeuwarden, Netherlands
- 7Aarhus University Hospital, Aarhus, Denmark
- 8St. Antonius Hospital, Nieuwegein, Netherlands
- 9Cardialysis B.V., Rotterdam, Netherlands
- 10AMC, Amsterdam, Netherlands
- 11Thoraxcenter, Erasmus Medical Center, Rotterdam, Netherlands
- 12Imperial College, London, United Kingdom
Post-dilatation (PD) of Absorb BVS has been proposed to improve post-procedural angiographic and subsequent device related clinical outcomes. Whether this recommendation is also applicable among patients undergoing BVS implantation in the setting of primary PCI (PPCI) remains unknown.
In the ABSORB STEMI TROFI II trial, 191 patients with STEMI undergoing PPCI were randomly assigned to treatment with Absorb BVS (N=95) or EES (N=96). Post-procedural minimal lumen diameter (MLD) as assessed by QCA and minimal intra-scaffold lumen area and healing score as assessed by OCT at 6 months were compared between Absorb BVS- and EES-treated patients stratified according to PD status.
PD was performed in 47 (50%) of Absorb BVS- and in 25 (26%) EES- treated patients. There were no difference in clinical characteristics including age, diabetic status, culprit vessel localization and pre-PPCI TIMI flow between Absorb BVS and EES or according to PD status. Similarly, no difference in terms of angiographic lesion length and pre-procedural MLD was noted. Direct stent implantation was less frequent in patients with PD (Absorb BVS: 25% vs 64%, P<0.001; EES 28% vs 56%, P=0.02). Post-procedural in-stent MLD was similar among patients with vs without PD (Absorb BVS: 2.44±0.33mm vs 2.48±0.33mm, p=0.54; EES: 2.46±0.50mm vs 2.47±0.37mm, P=0.93). OCT follow-up at 6 months was available in 84 Absorb BVS- (PD: N=41) and 86 EES-treated patients (PD: N=23). No difference in minimal in-stent lumen area and healing score was observed in patients with versus without PD at 6 months (Absorb BVS: 5.07±1.68mm2 vs 5.72±1.77mm2, p=0.09 and 1.55±2.61 vs 1.92±2.17, p=0.48; EES: 5.46±2.18mm2 vs 5.55±1.77mm2, p=0.85 and 2.50±3.33 vs 2.90±4.80, p=0.72).
Post-dilatation was not associated with improved device expansion or arterial healing parameters following primary PCI with either Absorb BVS or EES in ABSORB STEMI TROFI II.
CORONARY: Stents: Bioresorbable Vascular Scaffolds