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Effects of Coronary Artery Revascularization with a Polymer-Free Biolimus A9-Coated BioFreedom Stent Versus Bypass

Kyu Kim1, Choongki Kim1, Byeong Keuk Kim2

  • 1Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.

Yonsei Medical Journal
|May 12, 2018
PubMed

Insights

Polymer-free BioFreedom stenting allows more patients to undergo major noncardiac surgery sooner and at a lower cost compared to coronary artery bypass grafting (CABG). This revascularization strategy is feasible and safe for selected patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Surgery

Background:

  • Patients requiring revascularization before major noncardiac surgery face treatment decisions impacting surgical timing and outcomes.
  • Coronary artery bypass grafting (CABG) is a traditional revascularization method, but its associated delays and resource utilization can be significant.
  • Novel revascularization strategies are needed to optimize patient management in this setting.

Purpose of the Study:

  • To compare the efficacy and safety of polymer-free drug-coated BioFreedom stent implantation versus CABG for revascularization prior to major noncardiac surgery.
  • To evaluate key outcomes including the rate and timing of noncardiac surgery and composite adverse events.

Main Methods:

  • A multicenter registry study involving 55 patients needing revascularization before non-delayed major noncardiac surgery.
  • Patients were divided into two groups: BioFreedom stent implantation (n=27) and CABG (n=28).
  • Primary outcomes assessed included noncardiac surgery rate, time to surgery, and a composite of death, myocardial infarction, stent thrombosis, stroke, repeat revascularization, or major bleeding.

Main Results:

  • A significantly higher rate of major noncardiac surgery was achieved with BioFreedom stenting (92.6%) compared to CABG (64.3%; p=0.027).
  • Time from revascularization to noncardiac surgery was shorter with BioFreedom (38.0 days) versus CABG (73.0 days; p=0.042).
  • The BioFreedom group experienced shorter hospital stays and lower treatment costs, with no significant difference in primary composite outcomes during the revascularization hospitalization or noncardiac surgery hospitalization.

Conclusions:

  • Polymer-free BioFreedom stenting is a feasible and safe revascularization option before major noncardiac surgery in selected patients.
  • This approach facilitates timely progression to noncardiac surgery and offers potential economic benefits.
  • Further research may explore its application in patients with less severe coronary artery disease.
Abstract

Keywords:
Percutaneous coronary interventioncoronary artery bypassdrug-coated stentpreoperative care

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