Dissections after bioresorbable vascular scaffold implantation in the POLAR ACS Registry
Wojciech Zasada1,2, Artur Dziewierz2,3, Lukasz Partyka1,4
1KCRI, Krakow, Poland.
Insights
Coronary artery dissection following bioresorbable vascular scaffold implantation occurred in 9% of patients. Lesion calcification was an independent factor for dissection during percutaneous coronary intervention (PCI).
Area of Science:
- Interventional Cardiology
- Cardiovascular Research
- Medical Device Technology
Background:
- Percutaneous coronary intervention (PCI) is a primary treatment for coronary artery disease.
- Coronary artery dissection is a frequent complication during PCI, often necessitating further intervention.
- Bioresorbable vascular scaffold (BVS) implantation requires precise vessel sizing, making dissection a key concern.
Purpose of the Study:
- To investigate the incidence and characteristics of coronary artery dissection after BVS implantation.
- To identify factors influencing dissection occurrence during PCI with BVS.
- To evaluate the clinical implications of dissection following BVS procedures.
Main Methods:
- Analysis of angiographic data from the POLAR ACS Registry.
- Assessment of dissection frequency, localization, and severity in 100 patients.
- Identification of demographic, clinical, and procedural factors associated with dissection.
Main Results:
- Significant dissection occurred in 9% of patients post-BVS implantation.
- Lesion calcification was identified as an independent risk factor for dissection during PCI.
- Groups with and without dissection showed similar demographics and predilatation rates; post-dilatation was more frequent in the dissection group.
Conclusions:
- Significant dissections after BVS implantation are treatable with good immediate angiographic outcomes.
- These positive angiographic results correlate with favorable long-term clinical outcomes.
- Careful lesion assessment, particularly for calcification, is crucial for minimizing dissection risk during BVS procedures.
Introduction:
Percutaneous coronary intervention (PCI) is a common method of treatment for patients with coronary artery disease. One of the most common complications during the PCI procedure is coronary artery dissection. It usually requires an additional action to assure the patency of the treated vessel.
Aim:
The aim of the publication is to describe the occurrence of coronary artery dissection after bioresorbable vascular scaffold (BVS) implantation. This selected type of PCI procedure is especially interesting because precise target vessel measurement before BVS implantation is required for optimal determination of scaffold size.
Material And Methods:
Based on angiographic data gathered in the POLAR ACS Registry, we assessed the frequency of dissections, their localization, and severity. Based on data regarding patients' demographic, clinical status, and details regarding treatment strategy, the factors that could have an influence on the dissection occurrence were identified.
Results:
A group of 100 patients included in the analyses. Group A consisted of 9 patients. This group was defined as patients in whom the significant dissection occurred after the BVS implantation. Group B comprised 91 patients. Both groups were very similar according to demographic data. The frequency of predilatation was similar; post-dilatation was performed more often in group A but without statistical significance. The presence of calcification in the target lesion was an independent factor of dissection during the index PCI procedure.
Conclusions:
The occurrence of significant dissection can be effectively treated, and the good angiographic results of this treatment immediately after the initial procedure translate into good clinical results in longer follow-up.
