Author + information
- Himanshu Rai1,
- Fernando Alfonso2,
- Michael Maeng3,
- Jens Wiebe4,
- Javier Cuesta Cuesta5,
- Evald Christiansen3,
- Petra Hoppmann6,
- Sebastian Kufner4,
- Simon Schneider6,
- Karl-Ludwig Laugwitz7,
- Adnan Kastrati8 and
- Robert Byrne4
- 1ISAResearch Centre, Deutsches Herzzentrum München (German Heart Centre Munich), Munich, Germany
- 2Hospital Universitario de la Princesa, Madrid, Spain
- 3Aarhus University Hospital, Aarhus, Denmark
- 4Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
- 5Hospital La Princesa, Madrid, Spain
- 6Medizinische Klinik, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
- 7Klinikum rechts der Isar TUM, Munich, Germany
- 8Deutsches Herzzentrum München, Munich, Germany
Bioresorbable stents (BRS) are novel devices designed to overcome the long-term limitations of permanent stent implantation. Optical coherence tomography (OCT) surveillance can provide important insights on the process of vessel wall healing after BRS implantation. We sought to evaluate OCT-assessed healing at 6 months after implantation of everolimus eluting BRS in patients treated for acute myocardial infarction (AMI).
ISAR-Absorb MI is a multicentre, assessor-blind randomized trial comparing outcomes of patients with AMI undergoing treatment with everolimus eluting BRS or conventional everolimus-eluting stents with angiographic surveillance planned for all patients at 6-8 months follow-up. Selected patients who had OCT surveillance (with commercially-available frequency domain OCT imaging) performed at the time of angiographic follow-up were included for the present analysis. Raw data of OCT image acquisitions were collected at four recruiting centres and analysed at a centralized core laboratory. Morphometric analysis of contiguous cross-sections was performed at 1 mm longitudinal intervals within the stented segment using QIvus 184.108.40.206 software.
OCT imaging data at post stenting follow-up on a total of 45 patients / stented target lesions at a median of 212 days was available for analysis. Morphometric analysis revealed mean stented length to be 18.85±6.09 mm. Mean minimum lumen area was 5.43±1.98 mm2, while the minimum stent area was 6.02±1.82 mm2. Average lumen area was 6.99±2.16 mm2, while the average stent area was 7.36±2.07 mm2. The total number of frames assessed was 915, with a total of 8,556 visible struts. Overall strut coverage was 98.60%; 0.41% of struts were found to be malapposed. Mean thickness of neointimal coverage was 94.93±31.43 μm, while mean neointimal area was 0.35±0.46 mm2 and mean percentage stenosis was 5.39±6.56%. Four (8.89 %) patients required target lesion revascularization at follow-up.
In selected patients undergoing OCT imaging at 6-8 months after implantation of everolimus eluting BRS stents for AMI, we observed generally favourable healing characteristics with high rates of strut coverage and low rates of strut malapposition.
CORONARY: Stents: Bioresorbable Vascular Scaffolds