Lumen Gain and Restoration of Pulsatility After Implantation of a Bioresorbable Vascular Scaffold in Porcine Coronary Arteries

Lane, Jennifer P.; Perkins, Laura; Sheehy, Alexander; Pacheco, Erica; Frie, Michael; Lambert, Byron J.; Rapoza, Richard; Virmani, Renu

doi:10.1016/j.jcin.2013.11.024

Cited by 70 publications

(31 citation statements)

References 30 publications

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“…Recent 5-year follow-up results after Absorb implantation concluded that the mean lumen area tended to increase from 6 months to 1 year and 5 years [29] . Progressive lumen gain was also observed after Absorb implantation in porcine coronary arteries [30] , for which the lumen area kept stable up to 6 months and then showed a progressive increase from one to 3.5 years. These studies confirmed the lumen gain after scaffold implantation over the degradation times, especially from 6 months onwards.…”

Section: Degradation Behaviourmentioning

confidence: 73%

Research into biodegradable polymeric stents: a review of experimental and modelling work

Qiu¹,

Zhao²

2018

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Bioresorbable stents (BRSs) are regarded as the next-generation medical devices to treat blocked or diseased arteries.The use of BRSs aims to reduce the risk of late stent thrombosis and long-term tissue inflammation associated with permanent metallic stents. BRSs are designed to relieve symptoms immediately and also provide mechanical support for an appropriate time period before they are fully absorbed by human body. To promote clinical adoption of BRSs or even to substitute metallic stents, the mechanical performance of BRSs needs to be thoroughly investigated and quantitatively characterised, especially over the full period of degradation. This paper offers a review of current research status of polymeric BRSs, covering both experimental and modelling work. Review of experimental studies highlighted the effects of stent designs and materials on the behaviour of polymeric BRSs. Computational work was able to simulate crimping, expansion and degradation of polymeric BRSs and the results were useful for performance assessment. In summary, the development of polymeric BRSs is still at an early stage, and further research is urgently required for a better understanding and control of their mechanical performance.

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Section: Degradation Behaviourmentioning

confidence: 73%

Research into biodegradable polymeric stents: a review of experimental and modelling work

Qiu¹,

Zhao²

2018

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“…Lately, bioresorbable vascular scaffolds (BVS) are in the focus of interest. Interestingly, for both “metallic free” concepts of BVS and DCB-only angioplasty, late lumen enlargement has been shown, which is contrary to the well-known vessel response after POBA, BMS or DES implantation resulting always in late lumen loss [38, 39]. Also, restoration of vasomotion after angioplasty is advantageous and might maintain positive long-term outcomes including relief of angina symptoms [39, 40].…”

Section: Discussionmentioning

confidence: 99%

Fractional flow reserve-guided coronary angioplasty using paclitaxel-coated balloons without stent implantation: feasibility, safety and 6-month results by angiography and optical coherence tomography

et al. 2016

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BackgroundPercutaneous coronary interventions (PCI) with drug-coated balloons (DCB) might be a promising trade-off between balloon angioplasty and drug-eluting stents, since DCB inhibit neointimal proliferation and limit duration of dual antiplatelet therapy. We investigated the safety, feasibility, and 6-month results of fractional flow reserve (FFR)-guided use of the paclitaxel-coated SeQuent Please® balloon without stenting for elective PCI of de novo lesions.Methods and resultsIn 46 patients (54 lesions) with stable symptomatic coronary artery disease (CAD), a FFR-guided POBA (plain old balloon angioplasty) was performed. In case of a sufficient POBA result with residual stenosis < 40 %, FFR > 0.8 and no severe dissection, the target lesion was finally dilated using the DCB. Quantitative coronary angiography (QCA) was performed before and after the index procedure and at 6-month follow-up (f/u) to calculate late lumen loss (LLL) and net luminal gain (NLG). Optical coherence tomography (OCT) was performed at f/u to assess vascular remodeling. DCB-only treatment was applied to 43 patients (51 lesions), while 3 patients (3 lesions) needed provisional stenting. Invasive f/u was completed in 39 patients (47 lesions). At the stenotic site, the lumen diameter showed a trend toward progressive increase at f/u (LLL: −0.13 ± 0.44 mm, n.s.; NLG: 1.10 ± 0.53 mm, p < 0.001) without aneurysm formation or restenosis after DCB-only treatment.ConclusionsFFR-guided DCB-only PCI of de novo lesions appeared feasible and safe in stable CAD with clopidogrel discontinuation after 4 weeks, showing a trend toward positive vessel remodeling without lumen loss at 6 months.Clinical trial registration http://www.clinicaltrials.gov. Unique identifier: NCT02120859Electronic supplementary materialThe online version of this article (doi:10.1007/s00392-016-1019-4) contains supplementary material, which is available to authorized users.

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“…There are many potential advantages of using BVS in SCAD. BVS offers the theoretical advantage of restoration of native vessel vasomotion and adaptive shear stress allowing a process of late luminal enlargement and late expansive remodeling once the scaffold degraded [14]. Moreover, even if the radial strength of the device is still limited compared to a metal platform, it is probably enough to fix the intimal flap preventing a further expansion of the hematoma.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous coronary artery dissection treated with biovascular scaffolds guided by intravascular ultrasounds imaging

Cerrato¹,

Tomassini²,

Rolfo³

et al. 2016

Cardiovasc Interv and Ther

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Lumen Gain and Restoration of Pulsatility After Implantation of a Bioresorbable Vascular Scaffold in Porcine Coronary Arteries

Cited by 70 publications

References 30 publications

Research into biodegradable polymeric stents: a review of experimental and modelling work

Research into biodegradable polymeric stents: a review of experimental and modelling work

Fractional flow reserve-guided coronary angioplasty using paclitaxel-coated balloons without stent implantation: feasibility, safety and 6-month results by angiography and optical coherence tomography

Spontaneous coronary artery dissection treated with biovascular scaffolds guided by intravascular ultrasounds imaging

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