First Report of Edge Vascular Response at 12Months of Magmaris, A Second-Generation Drug-Eluting Resorbable Magnesium Scaffold, Assessed by Grayscale Intravascular Ultrasound, Virtual Histology, and Optical Coherence Tomography. A Biosolve-II Trial Sub-Study. - 2019

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CONCLUSION: At 12months, Magmaris EVR assessment does not show overall significant changes, except for a fibrous plaque area reduction in the proximal segment. This could be translated as a benign healing process at the edges of the RMS. Copyright (c) 2019 Elsevier Inc. All rights reserved. INTRODUCTION AND OBJECTIVE: The edge vascular response (EVR) remains unknown in second generation drug-eluting Resorbable Magnesium Scaffold (RMS), such as Magmaris. The aim of the study was to evaluate tissue modifications in the RMS edges over time, assessed by different invasive imaging modalities. METHODS: The patients treated with the device were assessed by optical coherence tomography (OCT), grayscale intravascular ultrasound (IVUS), and virtual histology IVUS at baseline and 12months. The EVR study performed a segment- and frame-level analysis of the 5mm segments proximal and distal of the actual RMS. RESULTS: The segment-level grayscale IVUS (n=10), virtual histology IVUS (n=10), and OCT (n=18) analysis did not show any significant changes after 12months, except for a fibrous plaque area (FPA) reduction of 0.5mm2 (p=0.017) in the proximal segment compared to baseline. In the frame-level analysis, IVUS evaluation revealed a vessel area decreased 2.80+/-1.43mm2 (p=0.012) and 2.49+/-1.53mm2 (p=0.022) in 2 proximal frames. This was accompanied by plaque area reduction of 0.88+/-0.70mm2 (p=0.048) and a FPA decreased by 0.63+/-0.48mm2 (p=0.004) in one proximal frame. In 1 distal frame, there was a dense calcium area reduction of 0.10+/-0.12mm2 (p=0.045), FPA and fibrous fatty plaque increased 0.54+/-0.53mm2 (p=0.023) and 0.17+/-0.16mm2 (p=0.016), respectively. By OCT, there was a lumen area decrease of 0.76+/-1.51mm2 (p=0.045) in a distal frame. SUMMARY: The edge vascular response (EVR) remains unknown in second generation drug-eluting absorbable metal scaffolds (RMS), such as Magmaris. Patients treated with the device were assessed by multi invasive imaging modalities [i.e. optical coherence tomography (OCT), grayscale intravascular ultrasound (IVUS), and virtual histology IVUS] evaluating the tissue changes over time in the segment- and frame-level analysis of the 5mm segments proximal and distal of the actual RMS. As a result, after 12months, Magmaris EVR assessment does not show overall significant changes, except for a fibrous plaque area reduction in the proximal segment, translating a benign healing process at the edges of the RMS.


English

1878-0938

10.1016/j.carrev.2019.02.019 [doi] S1553-8389(19)30152-6 [pii]


*Absorbable Implants
*Angioplasty, Balloon, Coronary/is [Instrumentation]
*Coronary Artery Disease/th [Therapy]
*Drug-Eluting Stents
*Magnesium
*Tomography, Optical Coherence
*Ultrasonography, Interventional
Adult
Aged
Angioplasty, Balloon, Coronary/ae [Adverse Effects]
Coronary Artery Disease/dg [Diagnostic Imaging]
Coronary Artery Disease/pa [Pathology]
Fibrosis
Humans
Middle Aged
Plaque, Atherosclerotic
Predictive Value of Tests
Prosthesis Design
Risk Factors
Time Factors
Treatment Outcome
Wound Healing
Young Adult


MedStar Heart & Vascular Institute


Journal Article