Abstract
AIMS: The aim of the study was to assess the vascular healing response after Absorb bioresorbable vascular scaffold (BVS) implantation in patients with ST segment elevation myocardial infarction (STEMI) utilizing truly serial optical coherence tomography (OCT) examination at baseline, 12- and 24-months.
METHODS AND RESULTS: This is the single-centre, prospective, longitudinal study with baseline, 12- and 24-month OCT evaluation of 18 STEMI patients treated with 22 Absorb BVS implantation. The healing pattern was evaluated based upon lumen area, neointimal hyperplasia, strut coverage and apposition. The lumen area decreased at 12 months compared to baseline (8.52± 1.69 mm2 vs. 7.0±1.70 mm2, p<0.01), but it did not change from that point onward up to 24 months (7.0±1.70mm2 vs. 6.94±1.65mm2, p= 0.92). At 12 months after the index procedure the mean neointimal thickness was 217±69 μm and further neointimal hyperplasia was observed between 12 and 24 months though less pronounced (Δ62±44μm, p<0.0001). Full circumferential coverage of the vessel wall by neointima was observed in 92% of frames at 24 months. The low number of malapposed struts at the index procedure (<5%) further decreased over the observation period and was found in only one patient at 12 and 24 months. The ratio of uncovered struts was low both at 12 and 24 months.
CONCLUSIONS: This serial OCT analysis indicates continued healing process of the second generation BVS in STEMI population, as expressed by moderate neointimal growth, preserved lumen area and no late acquired malapposition.
Kochman, Janusz