Clinical Research
A Comparison of the Conformability of Everolimus-Eluting Bioresorbable Vascular Scaffolds to Metal Platform Coronary Stents

https://doi.org/10.1016/j.jcin.2010.07.016Get rights and content
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Objectives

The aim of this study was to assess the differences in terms of curvature and angulation of the treated vessel after the deployment of either a metallic stent or a polymeric scaffold device.

Background

Conformability of metallic platform stents (MPS) is the major determinant of geometric changes in coronary arteries caused by the stent deployment. It is not known how bioresorbable polymeric devices perform in this setting.

Methods

This retrospective study compares 102 patients who received an MPS (Multi-link Vision or Xience V, Abbott Vascular, Santa Clara, California) in the SPIRIT FIRST and II trials with 89 patients treated with the Revision 1.1 everolimus-eluting bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California) from cohort B of the ABSORB (A bioabsorbable everolimus-eluting coronary stent system) trial. All patients were treated with a single 3 × 18 mm device. Curvature and angulation were measured with dedicated software by angiography.

Results

Both the MPS and BVS groups had significant changes in relative region curvature (MPS vs. BVS: 28.7% vs. 7.5%) and angulation (MPS vs. BVS: 25.4% vs. 13.4%) after deployment. The unadjusted comparisons between the 2 groups showed for BVS a nonsignificant trend for less change in region curvature after deployment (MPS vs. BVS: 0.085 cm−1 vs. 0.056 cm−1, p = 0.06) and a significantly lower modification of angulation (MPS vs. BVS 6.4° vs. 4.3°, p = 0.03). By multivariate regression analysis, the independent predictors of changes in curvature and angulation were the pre-treatment region curvature, the pre-treatment region angulation, and the used device.

Conclusions

Bioresorbable vascular scaffolds have better conformability than conventional MPS. The clinical significance of the observed differences will require further investigation.

Key Words

angulation
bioresorbable
curvature
conformability
stent

Abbreviations and Acronyms

BVS
bioresorbable vascular scaffold(s)
EES
everolimus-eluting stent(s)
MPS
metallic platform stent(s)
QCA
quantitative coronary angiography
WSS
wall shear stress
2D
2-dimensional

Cited by (0)

The ABSORB cohort B and the SPIRIT I and II trials have been supported by Abbott. The authors are also grateful to the Spanish Society of Cardiology for the grant awarded to the first author. Dr. Ormiston is on the advisory board and received honoraria from Boston Scientific and Abbott Vascular. Dr. Smits received a research grant and speakers fees from Abbott Vascular. Dr. Windecker received lecture and consultant fees from Abbott, Biosensors, Boston Scientific, Cordis, and Medtronic. Drs. Veldhof and Dorange are employees of Abbott Vascular. Dr. Dudek is an advisory board member and speaker of Abbott Vascular. All other authors have reported that they have no relationships to disclose.