Background: Procedural technique may affect clinical outcomes after bioresorbable vascular scaffold (BVS) implantation. Prior studies suggesting such a relationship have not adjusted for baseline patient and lesion characteristics that may have influenced operator choice of technique and outcomes.
Objectives: This study sought to determine whether target lesion failure (TLF) (cardiac death, target-vessel myocardial infarction, or ischemia-driven target lesion revascularization) and scaffold thrombosis (ScT) rates within 3 years of BVS implantation are affected by operator technique (vessel size selection and pre- and post-dilation parameters).
Methods: TLF and ScT rates were determined in 2,973 patients with 3,149 BVS-treated coronary artery lesions from 5 prospective studies. Outcomes through 3 years were assessed according to pre-specified definitions of optimal technique. Multivariable analysis was used to adjust for differences in up to 18 patient and lesion characteristics.
Results: Optimal pre-dilation, vessel size selection, and post-dilation in all BVS-treated lesions were performed in 59.2%, 81.6%, and 12.4% of patients, respectively. BVS implantation in properly sized vessels was an independent predictor of freedom from TLF through 1 year and through 3 years, and of freedom from ScT through 1 year. Aggressive pre-dilation was an independent predictor of freedom from ScT between 1 and 3 years, and optimal post-dilation was an independent predictor of freedom from TLF between 1 and 3 years.
Conclusions: In the present large-scale analysis from the major ABSORB studies, after multivariable adjustment for baseline patient and lesion characteristics, vessel sizing and operator technique were strongly associated with BVS-related outcomes during 3-year follow-up.

Additional Metadata
Keywords Bioresorbable vascular scaffold, Prognosis, Technique, Thrombosis
Persistent URL,
Journal Journal of the American College of Cardiology
Stone, G.W, Abizaid, A.C, Onuma, Y, Seth, A, Gao, R, Ormiston, J.A, … Serruys, P.W.J.C. (2017). Effect of Technique on Outcomes Following Bioresorbable Vascular Scaffold Implantation. Journal of the American College of Cardiology. doi:10.1016/j.jacc.2017.09.1106