Bioresorbable vascular scaffold overlap evaluation with optical coherence tomography after implantation with or without enhanced stent visualization system (WOLFIE study): a two-centre prospective comparison

Abstract

The aim of the current study was to assess the scan-rescan reproducibility of left ventricular (LV) kinetic energy (KE), viscous energy loss (EL) and vorticity during diastole from four-dimensional flow magnetic resonance imaging (4D flow MRI) in healthy subjects. Twelve volunteers (age 27 ± 3 years) underwent whole-heart 4D flow MRI twice in one session. In-scan consistency was evaluated by correlation between KE and EL. EL index was computed to measure the amount of EL relative to KE over diastole. Scan-rescan analysis was performed to test reproducibility of volumetric measurements of KE, EL, EL index and vorticity in the LV over early (E) and late (A) diastolic filling. In-scan consistency between KE and EL was strong-excellent (E-filling scan1: r = 0.92, P < 0.001; scan2: ρ = 0.96, P < 0.001 and A-filling scan1: ρ = 0.87, P < 0.001; scan2: r = 0.99, P < 0.001). For the majority of subjects (10 out of 12), KE and EL measures showed good to strong reproducibility. However, with a wide range of agreement [intraclass correlation (ICC): 0.64-0.95] and coefficients of variation (CV) ≤ 25%. EL index showed strong reproducibility for all 12 subjects with a strong ICC (0.94, P < 0.001) and a CV of 9%. Scan-rescan reproducibility of volumetric vorticity showed good-excellent ICCs (0.83-0.95) with CVs ≤ 11%. In conclusion, the current study shows strong-excellent in-scan consistency and overall good agreement between scans for 4D flow MRI assessment of left ventricular kinetic energy, energy loss and vorticity over diastole. However, substantial differences between the scans were also found in some parameters in two out of twelve subjects. Strong reproducibility was found in the dimensionless EL index , which measures the amount of viscous energy loss relative to the average kinetic energy over diastole.

Effectiveness and safety of the ABSORB bioresorbable vascular scaffold for the treatment of coronary artery disease: systematic review and meta-analysis of randomized clinical trials

“…In the last years, a European expert consensus (GHOST-EU registry) has proposed a specific protocol to be followed for the correct apposition of scaffolds, the so called "PSP technique" (27). This technique consists in preparation of the lesion, with Predilatation, accurate vessel Sizing (28,29), and mandatory post-dilatation (PSP) (30). Unfortunately, all data coming from big trials are on patients treated with BVS, enrolled between November 2011 and December 2015 (Figure 8).…”

“…5 [1] 14 [8] / / 19 [8] 23 [10] 7 [5] 9 [3] 3 [3] 4 [4] 25 [32] 25 [31] 184 [20] 42 [23] 106 [29] 218 [31] 363 [26] 61 [24] 49 [20] 36 [26)…”

“…63 [23] 41 [42] 34 [36] 21 [19] 24 [25] 318 [26] 298 [24] RCA [%] 56 [31] 95 [26] 194 [27] 404 [29] 59 [23] 63 [25] 43 [31) 85 [31] 13 [13] 17 [18] 40 [36] 24 [25] 348 [29] 401 [32] Clinical 16 [20] 13 [17] 192 [21] 185 [20] UA [%] 37 [22] 68 [30] 168 [25] 355 [27] 152 [64] 154 [65] 22 [16] 26 [10] …”

The impact of the 3-year ABSORB II trial results on my clinical practice: an Italian survey

“…The majority of the operators showed a well-established knowledge of the PSP technique (pre-dilatation, sizing to 1:1, post-dilatation with noncompliant balloon) (8)(9)(10)(11). Sixty-one percent of the operators affirmed that they use the PSP technique in all the cases of BSV implantation, while 29% use it in more than 75% of cases.…”

Intracoronary Imaging

“…As far as novel bioresorbable stents are concerned, ultrasound crosses the scaffold with only mild reflection and no acoustic shadowing and the struts appear as moderately echogenic lines. With OCT, the polymeric scaffold is perfectly outlined as box-like structures, with no shadowing, and its changes over time in the period of bioabsorption can be assessed 29 30…”