Author + information
- Erhan Tenekecioglua,b,
- Yohei Sotomia,b,
- Ryo Toriia,b,
- Christos Bourantasa,b,
- Yosuke Miyazakia,b,
- Solomon Sua,b,
- Yoshinobu Onumaa,b and
- Patrick Serruysa,b
Background: Protrusion status of scaffold struts is related with the local coronary flow dynamics in treated segments. Emerging scaffold thrombosis events have inspired us to investigate protrusion status of the different types of scaffolds and its relations with endothelial shear stress(ESS).
Methods: Six Absorb everolimus-eluting Bioresorbable Vascular Scaffolds and 11 Mirage sirolimus-eluting Bioresorbable Microfiber Scaffolds were implanted in coronaries of eight mini pigs. Optical coherence tomography(OCT) was performed post-scaffold implantation and obtained images were fused with angiographic data to reconstruct the 3 dimensional coronary anatomy. Blood flow simulation was performed and ESS distribution was estimated for each scaffold. Embedment/protrusion analysis were performed with a special version of QCU-CMS(version 4.69, Leiden University Medical Center, Netherlands). Two animals were sacrificed at 30-day post-implantation to examine the histological changes within the scaffolded segments in Absorb(n=2) and Mirage(n=2).
Results: Mean ESS [0.73±2.19Pa vs.0.93±1.83 Pa;p=0.14]and embedment depth (22±37μm vs. 17±33μm,p=0.45)were comparable between Absorb and Mirage. A significant difference was observed in the protrusion distance(151±137 μm for Absorb,130±143μm for Mirage;p=0.035). Strut protrusion distance of Absorb presented an inverse correlation with ESS(r=-0.369,p<0.0001),whereas that of Mirage had a positive correlation with EES(r=0.192,p<0.0001). Comparable percentages of vessel luminal surface exposed to recirculations in the vicinity of the struts were estimated in both types of scaffold groups. Histopathology revealed minimal inflammatory changes in both scaffold groups. At 30-day, endothelial coverage was less in Absorb. Due to increased neointimal hyperplasia, diameter stenosis was higher in Mirage.
Conclusions: Embedment depth was similar between both groups, while protrusion distance was higher in Absorb than in Mirage. Inverse correlation of protrusion distance with ESS in Absorb(rectangular strut)and positive correlation in Mirage(circular strut) suggested the impact of strut shape on flow dynamics.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Intervention in Interventional Cardiology: Advanced Device Use
Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices
Presentation Number: 1155-164
- 2017 American College of Cardiology Foundation