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Bioresorbable coronary stent for the treatment of complex coronary lesions: Data from an all-comer registry
Andrea Cuculo1, Antonio Ruggiero1, Antonio Centola1
1Cardiology Departement, Ospedali Riuniti University Hospital, Foggia, Italy.
Insights
Bioresorbable vascular scaffolds (BVS) show comparable safety to everolimus-eluting stents (EES) in complex coronary lesions. Further assessment is needed for BVS use in very high SYNTAX score cases.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Biomaterials Science
Background:
- An all-comers registry evaluated patients undergoing coronary angioplasty treated with bioresorbable vascular scaffolds (BVS).
- The study compared BVS outcomes against everolimus-eluting stents (EES) in a control group.
Purpose of the Study:
- To assess the safety and efficacy of BVS in a real-world, unselected patient population undergoing coronary angioplasty.
- To compare clinical outcomes between BVS and EES in patients with complex coronary lesions (Type B/C).
Main Methods:
- Fifty-five consecutive patients treated with BVS for Type B/C coronary lesions were enrolled.
- Clinical and procedural characteristics were recorded for BVS and EES groups.
- Statistical analysis compared adverse event incidence and follow-up outcomes.
Main Results:
- No statistically significant difference in adverse events between BVS and EES groups.
- Differences in lesion type, coronary bifurcation treatment, and SYNTAX score were significant.
- After multivariable correction, only SYNTAX score remained a significant differentiator.
Conclusions:
- BVS demonstrates a comparable safety profile to EES in complex coronary lesions within an all-comers registry.
- The application of BVS in specific complex scenarios, particularly those with very high SYNTAX scores, requires further investigation.
Background:
The study aimed to report the results from an all-comers registry of patients undergoing coronary angioplasty and treated with bioresorbable vascular scaffold (BVS).
Methods:
Fifty-five consecutive patients with type B/C coronary lesions according to the AHA classification and treated with BVS were enrolled in the study. The clinical and procedural characteristics of enrolled patients were recorded. Fifty-five consecutive subjects with coronary lesions type B/C treated with everolimus eluting stent (EES) were used as control group.
Results:
The incidence of adverse events was not statistically significant comparing subjects treated with BVS with those treated with EES. Non significant differences were also found in the follow-up considering the presence of diabetes, multivessel disease, use of more than one stent at the same time, diagnosis (STEMI vs UA/NSTEMI), use of coronary stents in overlapping. The differences were significant considering the type of lesion (Log-Rank p<0.05), stenoses treated in correspondence of a coronary bifurcation (p<0.05), the SYNTAX score (cut off 22) (p<0.001); after multivariable correction for age and gender, however, differences remained significant only for SYNTAX score.
Conclusions:
The use of BVS in an all-comers registry of patients undergoing coronary angioplasty on complex coronary lesions is associated with a safety profile comparable to that obtained with EES; the use of BVS in particular conditions, such as very high SYNTAX score, should be further assessed.
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