Cor Vasa 2017, 59(3):e251-e256 | DOI: 10.1016/j.crvasa.2016.11.007

Bioabsorbable stents in routine practice. New epoch in interventional cardiology

Jan Škvařil^*, Miroslav Černohous, Martin Hajšl, Pavel Sedloň, Miroslav Zavoral, Martin Malý

Kardiologické oddělení, Interní klinika, 1. lékařská fakulta Univerzity Karlovy a Ústřední vojenská nemocnice - Vojenská fakultní nemocnice Praha, Praha, Česká republika

Introduction: According to contemporary experience, bioabsorbable vascular scaffolding (BVS) implantation represents promising perspective in cardiology interventions. In the cathlab of Central Military Hospital in Prague, the program of BVS implantation started in June 2013.
Patient cohort and methods: From June 2013 to October 2015, 107 procedures of BVS implantation in 98 patients were performed. Total of 110 lesions were treated. In nine patients BVS was implanted in two stages. In three patients, the intervention of two vessels was performed during one procedure, always using BVS. Non-randomized data of three cohorts of patients were evaluated: STEMI (45 patients), NSTEMI (34 patients), and elective BVS implantations (31 patients). The three groups did not differ in basic demographic features. In STEMI group, initial thrombotic occlusion and consequent thrombaspiration were more often. In this (STEMI) group, the evaluation of the procedure is supplemented by CT performance after 12 months.

Results: The procedure was always technically successful except 1 case (NSTEMI). Residual diameter stenosis >20% was registered in 1 patient in each group. Except 1 case in STEMI group, final TIMI III flow was achieved in all cases. One patient died in NSTEMI group in consequence of definite stent thrombosis. The final angiographic result (recoil, residual stenosis) was evaluated with the aid of quantitative coronary analysis (QCA). It did not prove any statistically significant difference among the groups. The value of immediate recoil did not exceed 10% in all groups. Target Lesion Revascularization (TLR) was performed in two patients in STEMI group. Up to now, performed CT scans demonstrated persisting good results.

Conclusion: In accordance with contemporary literary data, our experience proves safety and efficacy of BVS implantation during coronary interventions in selected patients.

Keywords: Bioabsorbable vascular scaffolding; Elective PCI; Primary PCI; Quantitative coronary analysis

Received: May 22, 2016; Revised: November 10, 2016; Accepted: November 16, 2016; Published: June 1, 2017  Show citation