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To analyse the vasomotion of a coronary segment in relationship to its intravascular ultrasound–virtual histology (IVUS–VH) composition. Coronary segments, transiently scaffolded by a fully absorbable sirolimus eluting Mg scaffold (DREAMS 2G), may in the long-term recover a normal vasomotor tone. Recovery of an endothelial-dependent vasomotion may be enabled by scaffold bioresorption, composition of the native vessel wall, or a combination of both mechanisms.
The prospective, international, multi-centre, first-in-man BIOSOLVE-II trial enrolled 123 patients with up to 2 de novo lesions with a reference diameter between 2.2 and 3.7 mm. All patients were scheduled for angiographic follow-up at 6 months. Quantitative coronary angiography (QCA) - based vasomotion was assessed at 6 months in one clinical center.
At 6-month, the correlation between IVUS-VH necrotic core percentage and the change in QCA based minimum lumen diameter (MLD) in response to high dose of acetylcholine showed a Spearman estimate of -0.489 (p=0.055) and with fibrous volume of 0.53 (p=0.035). This means that the larger the necrotic core percentage the smaller the change in MLD in response to Ach and the contrary is true for fibrous volume, the larger the fibrous tissue the larger the change in MLD. There were no other significant correlations with fibro-fatty or dense calcium.
Vasomotion signs were observed at 6-month following implantation of the drug-eluting metal absorbable scaffold DREAMS 2G and there was a relationship with underlying IVUS- VH plaque composition.
CORONARY: Bioresorbable Vascular Scaffolds