Aims: Everolimus eluting ABSORB™ bioresorbable vascular scaffold (BVS) represents a novel approach for PCI with transient vessel support and drug delivery without the long term limitations of metallic DES. However, the current use of BVS is still restricted to non-complex lesions. The aim of this subgroup analysis was to evaluate the feasibility and performance of BVS in long lesions (>25 mm).
Methods and results: A single-centre allcomers Absorb registry was performed from October 2012 to December 2014. A total of 125 consecutive patients with 154 lesions (198 BVS) were included. 33.8%of them were long lesions (52 lesions), and 66.2% were non-long lesions (102 lesions). The male/female ratio was 98/27 among the study population, with mean age of 54±9 years. 16% had a family history of ischaemic heart disease, 71% were smokers, 47% had hypertension, 54% had dyslipidaemia, 4% had prior ischaemic heart disease and 2% prior PCI. The clinical presentation was ACS in 94,4% (43,5% NSTEMI, 33% STEMI). 25% had multi-vessel disease. Treated artery was the LAD in 48.1%, 13.6% CX, 29.9% RCA, 1.9% LM. Most of the lesions were B2 (59.1%), with 14.3% bifurcation lesions, 9.7% ostial lesions, 7.8% calcified lesions, 31.8% thrombotic lesions and 33.8% long lesions. Predilatation and postdilatation were done in 59.7/60.4%. Intracoronary imaging was performed in 80 patients, 91% OCT. The most frequent diameter used for BVS was 3.5 mm and the medium stent length was 20.5±5.6 mm. Implant success was achieved in 100% of patients. During a mean follow-up of 303±209 days there were 5.6% of MACE due to TLR (6 stent thrombosis, 2 intrastent restenosis), but with no deaths. There were 6 cases of stent thrombosis, 2 of which were due to non-adherence. All of them resolved with ACTP balloon or with a new BVS implant. Regarding the subgroup of patients with long lesions compared to non-long lesions patients, there were less diabetics (25% vs. 18.6%) and no differences in ostium involvement. Bifurcation lesion was present in 15.3 vs. 9.8%. Both pre-and post-dilation was more frequent preformed (76.9% vs. 50.9%; p=0.002) and (67.3 vs. 56.8%; p=0.21) respectively, probably due to more complex lesions (type B2 and C=57.6% vs. 29.4%; p=0.001) and more calcified lesions (13.4% vs. 4.9%; p=0.062). All CTOs were long lesions (p=0.04). There was higher number of scaffolds per lesion (>2 BVS in 51.9% vs. 9.8%; p |
