MedStar Authors catalog › Details for: Mechanism of Drug-Eluting Absorbable Metal Scaffold Restenosis: A Serial Optical Coherence Tomography Study.
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Mechanism of Drug-Eluting Absorbable Metal Scaffold Restenosis: A Serial Optical Coherence Tomography Study.

by Garcia-Garcia, Hector M.
Citation: Circulation: Cardiovascular Interventions. 13(3):e008657, 2020 03.; .Journal: Circulation. Cardiovascular interventions.Published: 2020; ; ; ISSN: 1941-7640.Full author list: Byrne R; Garcia-Garcia HM; Haude M; Joner M; Koolen J; Landmesser U; Losdat S; Otsuka T; Raber L; Rai H; Ueki Y; Windecker S.UI/PMID: 32093514.Subject(s): *Absorbable Implants | *Coronary Restenosis/dg [Diagnostic Imaging] | *Coronary Vessels/dg [Diagnostic Imaging] | *Metals/ch [Chemistry] | *Myocardial Ischemia/th [Therapy] | *Percutaneous Coronary Intervention/is [Instrumentation] | *Tomography, Optical Coherence | Aged | Cardiovascular Agents/ad [Administration & Dosage] | Coronary Restenosis/et [Etiology] | Female | Fibrosis | Humans | Male | Middle Aged | Myocardial Ischemia/dg [Diagnostic Imaging] | Neointima | Percutaneous Coronary Intervention/ae [Adverse Effects] | Predictive Value of Tests | Prospective Studies | Prosthesis Design | Sirolimus/ad [Administration & Dosage] | Time Factors | Treatment OutcomeInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1161/CIRCINTERVENTIONS.119.008657https://dx.doi.org/10.1161/CIRCINTERVENTIONS.119.008657 (Click here) | (Click here) Abbreviated citation: Circ., Cardiovasc. interv.. 13(3):e008657, 2020 03; .Local Holdings: Available online from MWHC library: 2008 - present.Abstract: BACKGROUND: The pathomechanisms underlying restenosis of the bioabsorbable sirolimus-eluting metallic scaffold (Magmaris) remain unknown. Using serial optical coherence tomography, we investigated causes of restenosis, including the contribution of late scaffold recoil versus neointimal hyperplasia.Abstract: CONCLUSIONS: In addition to neointimal hyperplasia, late scaffold recoil contributed significantly to LLL of sirolimus-eluting absorbable metal scaffolds. The extent of late scaffold recoil was dependent on the underlying plaque morphology and was the highest among fibrotic lesions. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT01960504.Abstract: METHODS: Patients enrolled in BIOSOLVE-II undergoing serial angiography and optical coherence tomography (post-intervention and follow-up: 6 months and/or 1 year) were analyzed. Patients were divided into 2 groups according to angiographic in-scaffold late lumen loss (LLL) <0.5 or >=0.5 mm. End points were late absolute scaffold recoil and neointimal hyperplasia area as assessed by optical coherence tomography.Abstract: RESULTS: Serial data were available for analysis from 70 patients (LLL <0.5 mm: n=41; LLL >=0.5 mm: n=29). Patient and lesion characteristics were comparable, and there was no significant difference in mean and minimal scaffold area between groups at post-intervention. Late absolute scaffold recoil was less among patients with LLL <0.5 mm (0.53+/-0.68 mm2) compared with those with LLL >=0.5 mm (1.48+/-1.20 mm2; P<0.001). Neointimal hyperplasia area was smaller among patients with LLL <0.5 mm at follow-up (1.47+/-0.33 mm2) compared with patients with LLL >=0.5 mm (1.68+/-0.34 mm2; P=0.013). In a matched-frame analysis (post-intervention and follow-up), late absolute scaffold recoil varied according to the underlying plaque type (lipid: 0.63+/-1.23 mm2; calcified: 0.81+/-1.44 mm2; and fibrous: 1.20+/-1.52 mm2; P <0.001), while there was no difference with regards to neointimal hyperplasia area (P=0.132).

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