Quality difference of neointima following the implantation of everolimus-eluting bioresorbable scaffolds and metallic stents in patients with ST-elevation myocardial infarction: Quantitative assessments by light intensity, light attenuation, and backscatter on optical coherence tomography in the TROFI II trial

Aims: We aimed to assess possible differences in neointimal quality after everolimus-eluting bioresorbable scaffold (BVS) implantation in comparison with cobalt-chromium everolimus-eluting scaffold (CoCr-EES) implantation by optical frequency domain imaging (OFDI). Methods and results: This study is a post hoc analysis of the TROFI II trial assessing neointimal quality six months after the implantation of BVS (N=82) and CoCr-EES (N=87) in STEMI patients. Neointimal light property analysis by OFDI fully automatically computed light attenuation, backscatter and light intensity for superficial and deep neointima. High light attenuation/backscatter and high light intensity are reportedly associated with lipidic change and tissue maturation, respectively. Superficial and deep neointima in BVS presented lower light attenuation than CoCr-EES (superficial: 0.77±0.15 vs. 1.27±0.55 mm-1, p<0.001; deep: 0.88±0.20 vs. 1.17±0.27 mm-1, p<0.001). Superficial neointima in BVS showed comparable backscatter to that of CoCr-EES (4.81±0.52 vs. 4.94±0.61, p=0.141), while deep neointima in BVS showed lower backscatter than that of CoCr-EES (4.60±0.62 vs. 4.97±0.62, p<0.001). Light intensity of superficial neointima was comparable between both arms (139±13 vs. 144±30, p=0.236), whereas light intensity of deep neointima in BVS was lower than CoCr-EES (129±14 vs. 138±21, p<0.001). Conclusions: The present OFDI comparison suggested that tissue maturation was comparable but lipidic change of neointima was less prominent after BVS than after CoCr-EES implantation.

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