Impact of post-dilation on the acute and one-year clinical outcomes of a large cohort of patients treated solely with the Absorb Bioresorbable Vascular Scaffold

José De Ribamar Costa, Alexandre Abizaid, Antonio L. Bartorelli, Robert Whitbourn, Robert Jan Van Geuns, Bernard Chevalier, Marcos Perin, Ashok Seth, Roberto Botelho, Patrick W. Serruys

Research output: Contribution to journalArticle

Abstract

Aims: We sought to determine the impact of post-dilation (PD) on clinical outcomes in a large cohort of patients treated only with the Absorb Bioresorbable Vascular Scaffold (BVS). Methods and results: We evaluated all consecutive patients enrolled in the multicentre, single-arm ABSORB EXTEND study up to June 2013. The study allowed treatment of up to two coronaries (diameter 2.0 to 3.8 mm) and the use of overlapping (lesion length 28 mm). Patients with severe lesion calcification/ tortuosity were excluded. Aggressive lesion predilation (balloon to artery ratio of 0.9-1.0) was mandatory, and PD was left to the operator's discretion. Patients were grouped according to whether PD was performed or not, and the one-year incidences of MACE and scaffold thrombosis were compared. A total of 768 patients were enrolled in the study; PD was performed in 526 (68.4%). There were no significant differences between the PD group and non-PD group in the majority of baseline characteristics, including the presence of mod-erate calcification and of B2/C lesions. Lesion length was similar (12.3±5.1 mm vs. 12.1±5.3 mm, p=0.6), as was RVD (2.6 mm for both groups, p=0.2). Residual in-scaffold stenosis (15.5±6.4% with PD, 15.0±6% without PD, p=0.3) and the need for bail-out scaffold/stent (4.2% with PD, 4.6% without PD, p=0.8) were comparable. Acute gain was higher in the non-PD group (1.14±0.3 mm vs. 1.21±0.4 mm, p=0.02). Clinical device success was 98.9% in both groups. At one year, there was no difference in MACE (5.4% in the PD group vs. 2.5% in the non-PD group, p=0.1). All individual components of TLR, death, and MI were similar as well as definite/probable scaffold thrombosis between the two groups. Conclusions: These results reflect very similar final angiographic and clinical results achieved with or with-out post-dilation in the treatment of low to moderately complex coronary lesions. Therefore, post-dilation should be performed whenever needed to optimise acute results.

Original languageEnglish
Pages (from-to)141-148
Number of pages8
JournalEuroIntervention
Volume11
Issue number2
DOIs
Publication statusPublished - Jun 1 2015

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Blood Vessels
Dilatation
Thrombosis
Stents
Pathologic Constriction
Arteries

Keywords

  • Bioresorbable scaffold
  • Coronary artery disease
  • Percutaneous coronary intervention
  • Post-dilation

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Impact of post-dilation on the acute and one-year clinical outcomes of a large cohort of patients treated solely with the Absorb Bioresorbable Vascular Scaffold. / De Ribamar Costa, José; Abizaid, Alexandre; Bartorelli, Antonio L.; Whitbourn, Robert; Van Geuns, Robert Jan; Chevalier, Bernard; Perin, Marcos; Seth, Ashok; Botelho, Roberto; Serruys, Patrick W.

In: EuroIntervention, Vol. 11, No. 2, 01.06.2015, p. 141-148.

Research output: Contribution to journalArticle

De Ribamar Costa, J, Abizaid, A, Bartorelli, AL, Whitbourn, R, Van Geuns, RJ, Chevalier, B, Perin, M, Seth, A, Botelho, R & Serruys, PW 2015, 'Impact of post-dilation on the acute and one-year clinical outcomes of a large cohort of patients treated solely with the Absorb Bioresorbable Vascular Scaffold', EuroIntervention, vol. 11, no. 2, pp. 141-148. https://doi.org/10.4244/EIJY15M05-06
De Ribamar Costa, José ; Abizaid, Alexandre ; Bartorelli, Antonio L. ; Whitbourn, Robert ; Van Geuns, Robert Jan ; Chevalier, Bernard ; Perin, Marcos ; Seth, Ashok ; Botelho, Roberto ; Serruys, Patrick W. / Impact of post-dilation on the acute and one-year clinical outcomes of a large cohort of patients treated solely with the Absorb Bioresorbable Vascular Scaffold. In: EuroIntervention. 2015 ; Vol. 11, No. 2. pp. 141-148.
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abstract = "Aims: We sought to determine the impact of post-dilation (PD) on clinical outcomes in a large cohort of patients treated only with the Absorb Bioresorbable Vascular Scaffold (BVS). Methods and results: We evaluated all consecutive patients enrolled in the multicentre, single-arm ABSORB EXTEND study up to June 2013. The study allowed treatment of up to two coronaries (diameter 2.0 to 3.8 mm) and the use of overlapping (lesion length 28 mm). Patients with severe lesion calcification/ tortuosity were excluded. Aggressive lesion predilation (balloon to artery ratio of 0.9-1.0) was mandatory, and PD was left to the operator's discretion. Patients were grouped according to whether PD was performed or not, and the one-year incidences of MACE and scaffold thrombosis were compared. A total of 768 patients were enrolled in the study; PD was performed in 526 (68.4{\%}). There were no significant differences between the PD group and non-PD group in the majority of baseline characteristics, including the presence of mod-erate calcification and of B2/C lesions. Lesion length was similar (12.3±5.1 mm vs. 12.1±5.3 mm, p=0.6), as was RVD (2.6 mm for both groups, p=0.2). Residual in-scaffold stenosis (15.5±6.4{\%} with PD, 15.0±6{\%} without PD, p=0.3) and the need for bail-out scaffold/stent (4.2{\%} with PD, 4.6{\%} without PD, p=0.8) were comparable. Acute gain was higher in the non-PD group (1.14±0.3 mm vs. 1.21±0.4 mm, p=0.02). Clinical device success was 98.9{\%} in both groups. At one year, there was no difference in MACE (5.4{\%} in the PD group vs. 2.5{\%} in the non-PD group, p=0.1). All individual components of TLR, death, and MI were similar as well as definite/probable scaffold thrombosis between the two groups. Conclusions: These results reflect very similar final angiographic and clinical results achieved with or with-out post-dilation in the treatment of low to moderately complex coronary lesions. Therefore, post-dilation should be performed whenever needed to optimise acute results.",
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AU - De Ribamar Costa, José

AU - Abizaid, Alexandre

AU - Bartorelli, Antonio L.

AU - Whitbourn, Robert

AU - Van Geuns, Robert Jan

AU - Chevalier, Bernard

AU - Perin, Marcos

AU - Seth, Ashok

AU - Botelho, Roberto

AU - Serruys, Patrick W.

PY - 2015/6/1

Y1 - 2015/6/1

N2 - Aims: We sought to determine the impact of post-dilation (PD) on clinical outcomes in a large cohort of patients treated only with the Absorb Bioresorbable Vascular Scaffold (BVS). Methods and results: We evaluated all consecutive patients enrolled in the multicentre, single-arm ABSORB EXTEND study up to June 2013. The study allowed treatment of up to two coronaries (diameter 2.0 to 3.8 mm) and the use of overlapping (lesion length 28 mm). Patients with severe lesion calcification/ tortuosity were excluded. Aggressive lesion predilation (balloon to artery ratio of 0.9-1.0) was mandatory, and PD was left to the operator's discretion. Patients were grouped according to whether PD was performed or not, and the one-year incidences of MACE and scaffold thrombosis were compared. A total of 768 patients were enrolled in the study; PD was performed in 526 (68.4%). There were no significant differences between the PD group and non-PD group in the majority of baseline characteristics, including the presence of mod-erate calcification and of B2/C lesions. Lesion length was similar (12.3±5.1 mm vs. 12.1±5.3 mm, p=0.6), as was RVD (2.6 mm for both groups, p=0.2). Residual in-scaffold stenosis (15.5±6.4% with PD, 15.0±6% without PD, p=0.3) and the need for bail-out scaffold/stent (4.2% with PD, 4.6% without PD, p=0.8) were comparable. Acute gain was higher in the non-PD group (1.14±0.3 mm vs. 1.21±0.4 mm, p=0.02). Clinical device success was 98.9% in both groups. At one year, there was no difference in MACE (5.4% in the PD group vs. 2.5% in the non-PD group, p=0.1). All individual components of TLR, death, and MI were similar as well as definite/probable scaffold thrombosis between the two groups. Conclusions: These results reflect very similar final angiographic and clinical results achieved with or with-out post-dilation in the treatment of low to moderately complex coronary lesions. Therefore, post-dilation should be performed whenever needed to optimise acute results.

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