Serial intravascular ultrasound virtual histology (IVUS-VH) after implantation of metallic stents has been unable to show any changes in the composition of the scaffolded plaque overtime. The everolimus-eluting ABSORB scaffold potentially allows for the formation of new fibrotic tissue on the scaffolded coronary plaque during bioresorption. We examined the 12 month IVUS-VH changes in composition of the plaque behind the struts (PBS) following the implantation of the ABSORB scaffold. Using IVUS-VH and dedicated software, the composition of the PBS was analyzed in all patients from the ABSORB Cohort B2 trial, who were imaged with a commercially available IVUS-VH console (s5i system, Volcano Corporation, Rancho Cordova, CA, USA), immediately post-ABSORB implantation and at 12 month follow-up. Paired IVUS-VH data, recorded with s5i system, were available in 17 patients (18 lesions). The analysis demonstrated an increase in mean PBS area (2.39 ± 1.85 mm2vs. 2.76 ± 1.79 mm2, P = 0.078) and a reduction in the mean lumen area (6.37 ± 0.90 mm2vs. 5.98 ± 0.97 mm2, P = 0.006). Conversely, a significant decrease of 16 and 30% in necrotic core (NC) and dense calcium (DC) content, respectively, were evident (median % NC from 43.24 to 36.06%, P = 0.016; median % DC from 20.28 to 11.36%, P = 0.002). Serial IVUS-VH analyses of plaque located behind the ABSORB struts at 12-month demonstrated an increase in plaque area with a decrease in its NC and DC content. Larger studies are required to investigate the clinical impact of these findings.

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Keywords Bioresorbable vascular scaffold, Coronary plaque, Everolimus, IVUS-VH, Necrotic core
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Journal International Journal of Cardiovascular Imaging
Brugaletta, S, Gomez-Lara, J, Garcia-Garcia, H.M, Heo, J.H, Farooq, V, van Geuns, R.J.M, … Serruys, P.W.J.C. (2012). Analysis of 1 year virtual histology changes in coronary plaque located behind the struts of the everolimus eluting bioresorbable vascular scaffold. International Journal of Cardiovascular Imaging, 28(6), 1307–1314. doi:10.1007/s10554-011-9981-4