Wetenschappelijk jaaroverzicht 2012 - Catharina Ziekenhuis

evaluated. Overall, 26 patients underwent the vasomotion test (18 at 12 and 8 at 24
months). Vasodilatory response to Ach was quantitatively associated with larger reductions
over time in polymeric strut echogenicity (y= -0.159x- 6.85; r= -0.781, P< 0.001). Scaffolded
segments with vasoconstriction to Ach had larger vessel areas (14.37 ± 2.50 vs. 11.85 ± 2.54
mm(2), P= 0.030), larger plaque burden (57.31 ± 5.96 vs. 49.09 ± 9.10%, P= 0.018), and larger
necrotic core (NC) areas [1.39 (+1.14, +1.74) vs. 0.78 mm(2) (+0.20, +0.98), P= 0.006]
compared with those with vasodilation.
CONCLUSION: Vasodilatory response to Ach, in coronary segments scaffolded by the
ABSORB BVS device, is associated with a reduction in echogenicity of the scaffold over time,
and a low amount of NC. In particular, the latter finding resembles the behaviour of a native
coronary artery not caged by an intracoronary device.
Impactfactor: 10.478
Koolen JJ
First serial assessment at 6 months and 2 years of the second generation of absorb
everolimus-eluting bioresorbable vascular scaffold: a multi-imaging modality study
Ormiston JA, Serruys PW, Onuma Y, Geuns RJ van, Bruyne B de, Dudek D, Thuesen L,
Smits PC, Chevalier B, McClean D, Koolen J*, Windecker S, Whitbourn R, Meredith I,
Dorange C, Veldhof S, Hebert KM, Rapoza R, Garcia-Garcia HM
Circ Cardiovasc Interv. 2012 Oct 1;5(5):620-32
BACKGROUND: Nonserial observations have shown this bioresorbable scaffold to have no
signs of area reduction at 6 months and recovery of vasomotion at 1 year. Serial
observations at 6 months and 2 years have to confirm the absence of late restenosis or
unfavorable imaging outcomes.
METHODS AND RESULTS: The ABSORB trial is a multicenter single-arm trial assessing the
safety and performance of an everolimus-eluting bioresorbable vascular scaffold. Forty-five
patients underwent serial invasive imaging, such as quantitative coronary angiography,
intravascular ultrasound, and optical coherence tomography at 6 and 24 months of followup.
From 6 to 24 months, late luminal loss increased from 0.16±0.18 to 0.27±0.20 mm on
quantitative coronary angiography, with an increase in neointima of 0.68±0.43 mm(2) on
optical coherence tomography and 0.17±0.26 mm(2) on intravascular ultrasound. Struts still
recognizable on optical coherence tomography at 2 years showed 99% of neointimal
coverage with optical and ultrasonic signs of bioresorption accompanied by increase in mean
scaffold area compared with baseline (0.54±1.09 mm(2) on intravascular ultrasound,
P=0.003 and 0.77 ±1.33 m(2) on optical coherence tomography, P=0.016). Two-year major
adverse cardiac event rate was 6.8% without any scaffold thrombosis.
CONCLUSIONS: This serial analysis of the second generation of the everolimus-eluting
bioresorbable vascular scaffold confirmed, at medium term, the safety and efficacy of the
new device. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique
identifier: NCT00856856.
Impactfactor: 6.058
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