Author + information
- Raghuram Palaparti1,
- Gopala Krishna Koduru2,
- Boochi Babu Mannuva3,
- Somasekhar Ghanta4,
- Srinivas Chowdary Parvathaneni5 and
- Purnachandra Rao Kondru6
Our aim is to report three and half year clinical outcomes of bioresorbable vascular scaffold (BVS), AbsorbTM (Abbott Vascular, Santa Clara, California) implantation in real-world population of patients with a high proportion of diabetics and complex lesions in a single centre.
Ninety one patients undergoing BVS implantation were included in a single-centre, prospective registry from Dec 2012 to June 2016 at Aayush hospital, Vijayawada, India. The primary outcomes were cardiac death, target lesion failure (TLF), defined as clinically driven target lesion revascularization and myocardial infarction (MI), defined as CK-MB rise five times ULN. A total of 91 patients received 141 scaffolds (1.54 scaffolds per patient). Of note, 58.2% of patients were below the age of 60 years, 61.54% patients were diabetics and 83.5% patients presented with acute coronary syndrome. Multivessel disease was noted in 47.93% patients. Type B2/C constituted 72.35% of lesions. One patient treated for in scaffold restenosis by implantation of another BVS. Coronary imaging was used initially in ten patients (11%). Post dilation was done in 94.51% of scaffolds. High pressure (18 or more atms) post dilatation was performed in 124 scaffolds (88%). Very high pressure (24 or 26 atms) postdilatation was performed in 33 scaffolds (23%). Ticagrelor or Prasugrel was used in 83 (92%) of patients.
No deaths occurred during the study period. Two patients received target lesion revascularization (TLR) in less than 12 hours (one surgery and one PCI) and 2 patients treated with TLR (one surgery and one PCI) in less than one year. Five patients had MI. Primary outcome at 30 days and 1 year was 7.6% and 9.8% respectively.
In this single center real-world all-comers registry, BVS demonstrated excellent short and long term results in complex lesions and diabetics. These results were achieved without image guidance in majority of the procedures. High pressure post dilatation within the recommended expansion limits of scaffold and use of newer antiplatelets in majority were probably responsible for the good results. The results were consistent with the prior safety and efficacy reported in other BVS trials.
CORONARY: Bioresorbable Vascular Scaffolds