Coronary evaginations and peri-scaffold aneurysms following implantation of bioresorbable scaffolds: incidence, outcome, and optical coherence tomography analysis of possible mechanisms
- Gori, Tommaso II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Rhein-Main, Germany
- Jansen, Thomas II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Rhein-Main, Germany
- Weissner, Melissa II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Rhein-Main, Germany
- Foin, Nicolas National Heart Centre Singapore, Singapore
- Wenzel, Philip II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Rhein-Main, Germany
- Schulz, Eberhard II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Rhein-Main, Germany
- Cook, Stéphane Hospital and University of Fribourg, Switzerland
- Münzel, Thomas II. Medizinische Klinik und Poliklinik, University Medical Center Mainz, Rhein-Main, Germany
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07.07.2016
Published in:
- European Heart Journal. - 2016, vol. 37, no. 26, p. 2040–2049
English
Background Peri-stent coronary evaginations may disturb flow and have been proposed as possible risk factor for late stent thrombosis. We describe incidence, predictors, and possible mechanisms of coronary evaginations 12 months after implantation of bioresorbable vascular scaffolds (BVS).Methods and results One hundred and two BVS implanted in 90 patients (age 63 ± 13 years, 71 males, 14 diabetics) were analysed with angiography and optical coherence tomography (OCT) 12 months after implantation. Evaginations were identified as any hollow in the luminal vessel contour between well-apposed struts and were classified as major when extending ≥3 mm with a depth ≥10% of the BVS diameter. Fifty-five (54%) of the BVS (50(56%) of the patients) had at least one evagination (6.1 ± 6.2 evaginations per BVS), with a mean volume of 1.9 ± 1.9 mm³. Major evaginations were only found in one patient, and in-BVS aneurysms in three patients (4BVS). The presence of evaginations was strongly associated with that of malapposition (P = 0.003) and strut fractures (P = 0.01). No association could be shown between the presence and volume of the evaginations and any clinical variable or the presence of uncovered struts (P > 0.5). Peri-strut low- intensity areas (PSLIA) were present in 29 (53%) of the BVS with evaginations and 12 (26%) of those without (P = 0.0049); their presence was independently associated with the presence, the number (P < 0.003) and volume of the evaginations (P = 0.004) and with that of strut fracture. Conclusions Optical coherence tomography-detected evaginations are relatively common after BVS implantation, but, as for modern drug-eluting metallic stents, major evaginations are very rare. Optical coherence tomography evidence of immature neointima and strut fractures were associated with more severe development of evaginations.
- Faculty
- Faculté des sciences et de médecine
- Department
- Médecine 3ème année
- Language
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- English
- Classification
- Medicine
- License
- License undefined
- Identifiers
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- RERO DOC 277379
- DOI 10.1093/eurheartj/ehv581
- Persistent URL
- https://folia.unifr.ch/unifr/documents/305047
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