Details

Autor(en) / Beteiligte

• Karanasos, Antonios, MD
• Simsek, Cihan, MD
• Gnanadesigan, Muthukarrupan, MSc
• van Ditzhuijzen, Nienke S., MSc
• Freire, Raphael, MD
• Dijkstra, Jouke, PhD
• Tu, Shengxian, PhD
• Van Mieghem, Nicolas, MD
• van Soest, Gijs, PhD
• de Jaegere, Peter, MD, PhD
• Serruys, Patrick W., MD, PhD
• Zijlstra, Felix, MD, PhD
• van Geuns, Robert-Jan, MD, PhD
• Regar, Evelyn, MD, PhD

Titel

OCT Assessment of the Long-Term Vascular Healing Response 5 Years After Everolimus-Eluting Bioresorbable Vascular Scaffold

Ist Teil von

• Journal of the American College of Cardiology, 2014-12, Vol.64 (22), p.2343-2356

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2014

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Background Although recent observations suggest a favorable initial healing process of the everolimus-eluting bioresorbable vascular scaffold (BVS), little is known regarding long-term healing response. Objectives This study assessed the in vivo vascular healing response using optical coherence tomography (OCT) 5 years after elective first-in-man BVS implantation. Methods Of the 14 living patients enrolled in the Thoraxcenter Rotterdam cohort of the ABSORB A study, 8 patients underwent invasive follow-up, including OCT, 5 years after implantation. Advanced OCT image analysis included luminal morphometry, assessment of the adluminal signal-rich layer separating the lumen from other plaque components, visual and quantitative tissue characterization, and assessment of side-branch ostia “jailed” at baseline. Results In all patients, BVS struts were integrated in the vessel and were not discernible. Both minimum and mean luminal area increased from 2 to 5 years, whereas lumen eccentricity decreased over time. In most patients, plaques were covered by a signal-rich, low-attenuating layer. Minimum cap thickness over necrotic core was 155 ± 90 μm. One patient showed plaque progression and discontinuity of this layer. Side-branch ostia were preserved with tissue bridge thinning that had developed in the place of side-branch struts, creating a neo-carina. Conclusions At long-term BVS follow-up, we observed a favorable tissue response, with late luminal enlargement, side-branch patency, and development of a signal-rich, low-attenuating tissue layer that covered thrombogenic plaque components. The small size of the study and the observation of a different tissue response in 1 patient warrant judicious interpretation of our results and confirmation in larger studies.