Multimodality intravascular imaging of bioresorbable vascular scaffolds implanted in vein grafts

Abstract

Introduction: There are no data presenting a serial assessment of vein graft healing after bioresorbable vascular scaffold (BVS) implantation at long-term follow-up. Aim: To describe ABSORB BVS healing in vein grafts by optical coherence tomography (OCT) and high-definition intravascular imaging (HD-IVUS) at long-term follow-up. Material and methods: The study group consisted of 6 patients. The first patient had serial OCT assessment of BVS implanted in the saphenous vein grafts (SVG) at baseline and at 3-, 6-, 18-month follow-up and the second patient had OCT assessment of BVS implanted in the SVG at baseline and 24-, 48-month follow-up. The second and the third patients had OCT and HD-IVUS imaging at baseline and 48-month follow-up. The last 3 patients had OCT imaging of BVS implanted in the native coronary artery at 48-month follow-up. Results: There were no differences in neointimal hyperplasia after BVS implantation between each time point. However, complete scaffold coverage was observed only 48 months after implantation. Out of 202 analyzed scaffold struts, there were 67 (33%) black boxes detectable at 48-month follow-up. HD-IVUS presented plaque burden up to 67% at the segment of BVS implantation at 48-months follow-up. There was a difference in neointimal hyperplasia thickness (1.27 (0.953-1.696) vs. 0.757 (0.633-0.848), p < 0.001) between a native coronary artery and BVS scaffolds at 48-month follow-up. Conclusions: Bioresorbable vascular scaffold implanted in SVG characterized moderate neointimal hyperplasia as excessive as compared to native coronary arteries at long-term follow-up. The complete scaffold coverage was observed only 48 months after implantation.

Short-term stent strut coverage: optical coherence tomography vs high-definition intravascular ultrasound

“…Prior studies that have noted the importance of HD-IVUS in the assessment of bioresorbable scaffolds, did not aim to investigate the early healing response [9,10]. The aim of this study was to assess the early stent strut coverage which is a surrogate for a stent thrombosis prevention.…”