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Coronary interventions

Impact of Absorb bioresorbable scaffold implantation technique on post-procedural quantitative coronary angiographic endpoints in ST-elevation myocardial infarction: a sub-analysis of the BVS STEMI STRATEGY-IT study

EuroIntervention 2019;15:108-115. DOI: 10.4244/EIJ-D-18-00504

1. Cardiovascular institute, Department of Cardiology, Hospital Clínic, Institut d’Investigacions Biomédiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain; 2. Department of Internal Medicine and Cardiology, Kitasato University School of Medicine, Sagamihara, Japan; 3. Cardiovascular Institute, Azienda Ospedaliero-Universitaria di Ferrara, Italy and Maria Cecilia Hospital, GVM Care and Research, E.S. Health Science Foundation, Cotignola, Italy; 4. Cardiac Department, Fatebenefratelli Hospital, Milan, Italy; 5. Cardiology Division, Santa Maria della Pietà Hospital, Nola (NA), Italy; 6. Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus and San Raffaele Scientific Institute, Milan, Italy; 7. Cardiology Division, ASST Bergamo Est, Seriate (BG), Italy


Aims: The aim of the study was to evaluate the impact of bioresorbable vascular scaffold (BRS) implantation technique on post-procedural quantitative coronary angiography (QCA) parameters in ST-elevation myocardial infarction (STEMI).

Methods and results: We assessed 442 STEMI patients who underwent BRS implantation in the BVS STEMI STRATEGY-IT study. Optimal BRS implantation was assessed using the PSP score, developed and validated in the GHOST-EU registry. We analysed post-implantation QCA parameters, including minimum lumen diameter (MLD) and maximum footprint, in patients with and without optimal BRS implantation, coded as maximum PSP score. Patients with optimal BRS implantation had higher post-procedural MLD and lower maximum footprint than those without. Multivariate analysis demonstrated that optimal BRS implantation was an independent predictor of high post-procedural MLD, defined as ≥2.4 mm for 2.5 or 3.0 mm BRS and ≥2.8 mm for 3.5 mm BRS. Thrombectomy before optimal BRS implantation showed a trend towards higher post-procedural MLD and lower maximum footprint. There was no relationship between optimal BRS implantation and device-oriented composite events at one year.

Conclusions: Optimal BRS implantation, as assessed by PSP score, was associated with better post-procedural QCA parameters in STEMI. Thrombectomy before optimal BRS implantation might improve angiographic results in STEMI. Long-term follow-up is needed to analyse the relationship between QCA parameters and clinical outcomes after BRS implantation in STEMI patients.

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