Clinical, Angiographic, and Procedural Correlates of Acute, Subacute, and Late Absorb Scaffold Thrombosis

Stephen G. Ellis, Giuseppe Steffenino, Dean J. Kereiakes, Gregg W. Stone, R. J. van Geuns, Alexandre Abizaid, Holger Nef, Bernardo Cortese, Luca Testa, Maurizio Menichelli, Corrado Tamburino, Tommaso Gori, Takeshi Kimura, Patrick W. Serruys, Salvatore Brugaletta, Manel Sabaté, Run Lin Gao

Research output: Contribution to journalArticle

Abstract

Objectives The authors sought to identify and verify independent correlates of device thrombosis from an analysis of multicenter trials and registries. Background Recent analyses suggest an increased risk of device thrombosis with Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, California) implantation compared with metallic drug-eluting stents, and data from moderate size studies suggest a risk relationship to vessel size and technique. Methods From 8,771 consecutively treated patients, 105 patients (1.2%) were identified with scaffold thrombosis within 1 year of implantation. They were matched 2:1 with controls selected randomly from nonthrombosis patients. Data-restricted multiple logistic analysis was used to identify significant independent covariates of the outcome. Results Early (within 1 month) scaffold thrombosis occurred in 69 patients and late (1 to 12 months) thrombosis occurred in 36 patients. Modelling found significant correlations of thrombosis to be final minimal lumen diameter <1.85 mm (odds ratio [OR]: 3.1; p = 0.004), off dual antiplatelet therapy (DAPT) status (OR: 3.1 to 3.5; p = 0.006 to 0.053), no post-dilatation with >1.1:1 balloon/scaffold ratio (OR: 2.3; p = 0.022), and reference vessel diameter <2.40 mm (OR: 2.1; p = 0.036). Conclusions Suboptimal vessel sizing, procedural technique, angiographic outcomes, and dual antiplatelet therapy discontinuation appear to be the principal determinants of Absorb scaffold thrombosis risk through 12 months after implantation.

Original languageEnglish
Pages (from-to)1809-1815
Number of pages7
JournalJACC: Cardiovascular Interventions
Volume10
Issue number18
DOIs
Publication statusPublished - Sep 25 2017

Keywords

  • Absorb
  • bioresorbable scaffold
  • thrombosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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