Andamiajes bioresorbibles de magnesio versus poliméricos: comparación in vivo de su comportamiento mecánico por OCT

Abstract

Background: Different mechanical properties have been suggested for metallic bioresorbable vascular scaffolds (BVS) in comparison to polymeric BVS. We aim to evaluate the acute mechanical performance of Magmaris ® scaffold in comparison to Absorb ® . Materials and Methods: Two groups of 10 coronary lesions treated with Magmaris ® and Absorb ® 1.1 (20584 vs. 21016 struts) were compared. In all cases, optical coherence tomographic (OCT) images were acquired after scaffold deployment. Baseline clinical, angiographic, and procedural characteristics were compared, including OCT evaluations. Results: No baseline clinical or angiographic significant differences were found between groups. The most common indication for revascularization was effort angina (60% vs. 70% p = 0.45) with no ST-elevation myocardial infarction (MI) cases. Main target artery was left anterior descending, with a mean vessel diameter of 3.46 ± 0.23 in Absorb ® and 3.52 ± 0.19mm in Magmaris ® groups (p = 0.56). All cases underwent pre-and post-dilatation with a procedural success rate of 100%. OCT analyses showed larger scaffold and vessel diameters in Magmaris ® group: 3.11 ± 0.38 mm versus 3.07 ± 0.36 mm, p = 0.03 and 4.12 ± 0.51 mm versus 4.04 ± 0.46 mm, p = 0.04. Despite the application of slightly higher postdilatation pressures to Magmaris ® devices (18.01 ± 2.15 vs. 17.20 ± 3.80 atm, p = 0.05), significantly lower percentages of disrupted and malapposed struts were identified within Magmaris ® scaffolds (0.15% vs. 0.27%, p = 0.03 and 1.06% vs. 1.46% p = 0.01). No cardiac death, target vessel-related MI, or clinically driven target lesion revascularization was reported in a 30-day follow-up. Conclusion: Mechanical properties of Magmaris ® scaffold allow achieving larger vessel and scaffold diameters in a safe manner, with lower rates of malapposition and scaffold disruption.

Acute Mechanical Performance of Magmaris vs. DESolve Bioresorbable Scaffolds in a Real-World Scenario

“…In our study of the two BRS devices, the mean eccentricity index after implantation of Magmaris was significantly higher than that of DESolve (0.89 ± 0.2 vs. 0.77 ± 0.10; p <0.001). This finding is supported by the data of Abellás-Sequeiros et al ( 15 ) and is of clinical relevance, as Suwannasom et al were able to demonstrate that post-procedural asymmetry was independently associated with device-oriented composite endpoints. Therefore, our data suggest a more favorable acute result for the Magmaris group, although both groups met the imaging criteria that were evaluated in the MUSIC trial ( 16 ).…”