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Lessons from the GHOST-EU registry.

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Bifurcation lesions are increasingly treated with bioresorbable vascular scaffolds (BVS). Techniques like provisional stenting are feasible, but long-term safety and efficacy data for BVS in coronary bifurcations are still pending.

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Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Biomaterials Science

Background:

  • Bifurcation lesions represent a significant challenge in coronary interventions.
  • Bioresorbable vascular scaffolds (BVS) are emerging as a treatment option for coronary bifurcations.
  • The GHOST-EU registry provides insights into current BVS use for bifurcations.

Purpose of the Study:

  • To evaluate the techniques and limitations of treating coronary bifurcations with bioresorbable vascular scaffolds (BVS).
  • To assess the feasibility of different stenting strategies in bifurcation lesions using BVS.
  • To anticipate the long-term outcomes of BVS in bifurcations, including scaffold resorption and restoration of vascular function.

Main Methods:

  • Analysis of data from the multicentre GHOST-EU registry.
  • Review of bench testing data related to BVS in bifurcations.
  • Evaluation of procedural techniques, including provisional strategy, side branch (SB) dilatation, T-kissing inflation, and elective double stenting.

Main Results:

  • BVS accounted for approximately 25% of patients treated for bifurcations in the GHOST-EU registry.
  • The provisional strategy is the predominant approach for BVS bifurcation treatment.
  • Specific techniques (SB dilatation, T-kissing inflation, crossover stenting, elective double stenting) appear feasible without scaffold disruption when performed correctly.

Conclusions:

  • Current techniques suggest that treating bifurcations with BVS is feasible.
  • The theoretical advantage of BVS includes restoration of normal anatomy and function post-resorption.
  • Long-term safety and efficacy data from the GHOST-EU registry are crucial for confirming the role of BVS in coronary bifurcations.