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Heart 99:98-105 doi:10.1136/heartjnl-2012-302598
  • Interventional cardiology
  • Original article

Clinical and intravascular imaging outcomes at 1 and 2 years after implantation of absorb everolimus eluting bioresorbable vascular scaffolds in small vessels. Late lumen enlargement: does bioresorption matter with small vessel size? Insight from the ABSORB cohort B trial

  1. Patrick W Serruys1
  1. 1Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands
  2. 2Department of Interventional Cardiology, Cardiovascular Center Aalst, Aalst, Belgium
  3. 3Department of Cardiology, Jagiellonian University, Krakow, Poland
  4. 4Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, Skejby, Aarhus, Denmark
  5. 5Department of Cardiology, Institut Hospitalier Jacques Cartier, Massy, France
  6. 6Department of Cardiology, Christchurch Hospital, Christchurch, New Zealand
  7. 7Department of Cardiology, Bern University Hospital, Bern, Switzerland
  8. 8Department of Cardiology, St Vincents Hospital, Melbourne, Fitzroy, Victoria, Australia
  9. 9Department of Interventional Cardiology, Maasstad Ziekenhuis Rotterdam, Rotterdam, The Netherlands
  10. 10Department of Interventional Cardiology, Catharina Ziekenhuis, Eindhoven, The Netherlands
  11. 11Department of Interventional Cardiology, Monash Medical Centre, Victoria, Australia
  12. 12Abbott Vascular, Santa Clara, California, USA
  13. 13Abbott Vascular, Diegem, Belgium
  14. 14Cardialysis B.V., Rotterdam, The Netherlands
  15. 15Department of Cardiology, Auckland City Hospital, Auckland, New Zealand
  1. Correspondence to Professor Patrick W Serruys, Interventional Cardiology Department, Erasmus MC, 's-Gravendijkwal 230, Rotterdam 3015 CE, The Netherlands; p.w.j.c.serruys{at}erasmusmc.nl
  • Received 18 June 2012
  • Revised 6 September 2012
  • Accepted 19 September 2012
  • Published Online First 31 October 2012

Abstract

Background The long-term results after second generation everolimus eluting bioresorbable vascular scaffold (Absorb BVS) placement in small vessels are unknown. Therefore, we investigated the impact of vessel size on long-term outcomes, after Absorb BVS implantation.

Methods In ABSORB Cohort B Trial, out of the total study population (101 patients), 45 patients were assigned to undergo 6-month and 2-year angiographic follow-up (Cohort B1) and 56 patients to have angiographic follow-up at 1-year (Cohort B2). The pre-reference vessel diameter (RVD) was <2.5 mm (small-vessel group) in 41 patients (41 lesions) and ≥2.5 mm (large-vessel group) in 60 patients (61 lesions). Outcomes were compared according to pre-RVD.

Results At 2-year angiographic follow-up no differences in late lumen loss (0.29±0.16 mm vs 0.25±0.22 mm, p=0.4391), and in-segment binary restenosis (5.3% vs 5.3% p=1.0000) were demonstrated between groups. In the small-vessel group, intravascular ultrasound analysis showed a significant increase in vessel area (12.25±3.47 mm2 vs 13.09±3.38 mm2 p=0.0015), scaffold area (5.76±0.96 mm2 vs 6.41±1.30 mm2 p=0.0008) and lumen area (5.71±0.98 mm2 vs 6.20±1.27 mm2 p=0.0155) between 6-months and 2-year follow-up. No differences in plaque composition were reported between groups at either time point. At 2-year clinical follow-up, no differences in ischaemia-driven major adverse cardiac events (7.3% vs 10.2%, p=0.7335), myocardial infarction (4.9% vs 1.7%, p=0.5662) or ischaemia-driven target lesion revascularisation (2.4% vs 8.5%, p=0.3962) were reported between small and large vessels. No deaths or scaffold thrombosis were observed.

Conclusions Similar clinical and angiographic outcomes at 2-year follow-up were reported in small and large vessel groups. A significant late lumen enlargement and positive vessel remodelling were observed in small vessels.

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