Author + information
- Hirofumi Hioki1,
- Salvatore Brugaletta2,
- Luis Ortega-Paz3,
- Kohki Ishida4,
- Ander Regueiro1,
- Xavier Freixa5,
- Victoria Martin Yuste6,
- Monica Masotti2 and
- Manel Sabate7
- 1Hospital Clinic, Barcelona, Spain
- 2Hospital Clinic Barcelona, Barcelona, Spain
- 3Hospital Clínic of Barcelona, Barcelona, Spain
- 4Kitasato University Hospital, Sagamiharashi, Japan
- 5Hospital Clinic of Barcelona, Toronto, Spain
- 6hospital clinic barcelona, barcelona, Spain
- 7Hospital Clínic; University of Barcelona, Barcelona, Spain
Proper bioresorbable vascular scaffold (BVS) implantation has shown to reduce device-related events. Whether it could affect acute recoil immediately BRS implantation is unknown. We aimed to analyze relationship between BRS implantation technique and BVS acute recoil.
In our institution, we identified 158 consecutive patients (mean age 58 years, 79% male, 78% acute coronary syndrome) who received BVS implantation from April 2012 to March 2017. Absolute acute recoil (AAR) was measured by the difference between mean diameter of final balloon (X) and mean lumen diameter of scaffold immediately after balloon deflation (Y). Relative acute recoil (RAR) was defined as (X-Y)/X and expressed as a percentage. The PSP scores, which analyze the goodness of BVS implantation, previously developed in the GHOST registry, were evaluated for each patient included in this study.
The AAR and RAR (median [interquartile range]) were 0.12mm [0.04-0.25] and 3.9% [1.4-8.0]. Compared to the patients with PSP-3 lower than median value, patients with PSP-3 higher than median value had a significantly lower AAR (0.09mm vs. 0.15mm, p <0.05) and RAR (2.6% vs. 5.1%, p <0.05). Inversely, PSP-1 and PSP-2 scores were not associated with acute recoil. Within PSP score variables, correct BVS sizing was significantly associated lower degree of AAR and RAR compared to oversizing (0.06mm vs. 0.16mm, p < 0.05; 2.0% vs. 5.1%, p < 0.05, respectively). Multivariate analysis showed that correct BVS sizing significantly reduce the incidence of AAR (OR, 0.18; 95%CI 0.07-0.47). ST-elevation myocardial infarction (OR, 0.48; 95%CI, 0.21-1.12), pre-dilation (OR, 0.93; 95%CI, 0.35-2.46), post-dilation with NC balloon larger up to 0.5mm (OR, 1.52; 95%CI, 0.70-3.28), and BVS: reference vessel diameter ratio (OR, 0.92; 95%CI, 0.43-1.96) were not associated with AAR.
Optimized BVS implantation, particularly choosing correct BVS size, could reduce acute recoil. Long-term follow-up is warranted to demonstrate whether AAR is related with clinical outcomes after BVS implantation.
CORONARY: Bioresorbable Vascular Scaffolds