One-Year Results of the Use of Absorb Bioresorbable Vascular Scaffold in Patients with Different Forms of Coronary Artery Disease as Compared to a Drug-Eluting Stent

Nabijon P. Yuldashev, Robert J. Gil, Ravshanbek D. Kurbanov

 
International Journal of Biomedicine. 2018;8(1):20-25.
DOI: 10.21103/Article8(1)_OA2
Originally published March 15, 2018

Abstract: 

The aim of this study was to evaluate the immediate and long-term (12 months) clinical and angiographic efficacy of myocardial revascularization using Absorb GT1 Bioresorbable Vascular Scaffold (BVS) in comparison to second-generation drug-eluting stent (DES) in patients with various forms of coronary artery disease (CAD).
Material and Methods: The study included 152 patients with CAD. There were 131 men and 32 women with an average age of 54.6±10.4 years. Patients' data were evaluated retrospectively from the medical records.
Results:

  • Implantation of BVS in patients with different forms of CAD did not cause any angiographic or clinical complications, either at the hospital or at 12-month observation stages, and the results were comparable to those of the DES group.
  • The technique of implanting BVS and the reception of dual antiplatelet therapy are the key factors for achieving positive results in real clinical practice.
  • The use of BVS-frameworks contributes to improving clinical, functional and laboratory indicators, while the observed positive dynamics are comparable to similar data of the DES group.
  • Regardless of the type of implanted stents, the survival rate among CAD patients within 12 months after stenting was 100%, while none of the respondents during this time developed acute MI or recurrence of angina attacks.
Keywords: 
Absorb bioresorbable vascular scaffold ● drug-eluting stent ● coronary artery disease ● dual antiplatelet therapy
References: 
  1. Ioseliani DG, Arablinskiĭ AV. [Immediate and long-term outcomes of the use of a Crossflex wire coronary stent in the treatment of patients with different forms of ischemic heart disease].Vestn Rentgenol Radiol. 2000(4):11-6. [Article in Russian]. PubMed
  2. Grüntzig A, Hopff H. [Percutaneous recanalization after chronic arterial occlusion with a new dilator-catheter (modification of the Dotter technique) (author's transl)]. Dtsch Med Wochenschr. 1976; 99(49):2502-10, 2511. PubMed
  3. D'Agostino RB, Russell MW, Huse DM, Ellison RC, Silbershatz H, Wilson PW, Hartz SC. Primary and subsequent coronary risk appraisal: new results from the Framingham Study. Am Heart J. 2000; 139(2 Pt 1):272-81. PubMed
  4. Miller JM, Ohman EM, Moliterno. Restenosis: the clinical issues. In: Topol EJ, editor. Texbook of Interventional Cardiology. Philadelphia: W. B. Saunders; 1999:393.
  5. Garg S, Serruys PW. Coronary stents: current status. J Am CollCardiol. 2010; 56(10 Suppl):S1-42. doi: 10.1016/j.jacc.2010.06.007. PubMed
  6. Nakazawa G, Otsuka F, Nakano M, Vorpahl M, Yazdani SK, Ladich E, et al. The pathology of neoatherosclerosis in human coronary implants bare-metal and drug-eluting stents.  J Am Coll Cardiol. 2011;57(11):1314-22. doi: 10.1016/j.jacc.2011.01.011. PubMed
  7. U.S. Food & Drug Administration. FDA Investigating Increased Rate of Major Adverse Cardiac Events Observed in Patients Receiving Abbott Vascular’s Absorb GT1 Bioresorbable Vascular Scaffold (BVS) - Letter to Health Care Providers. Available from: https://www.fda.gov/MedicalDevices/Safety/LetterstoHealthCareProviders/u...
  8. U.S. Food & Drug Administration. UPDATE on Increased Rate of Major Adverse Cardiac Events Observed in Patients Receiving Abbott Vascular’s Absorb GT1 Bioresorbable Vascular Scaffold (BVS) - Letter to Health Care Providers. Available from: https://www.fda.gov/MedicalDevices/Safety/LetterstoHealthCareProviders/u...
  9. Campeau L. Percutaneous radial artery approach for coronary angiography. Cathet Cardiovasc Diagn. 1989;16(1):3-7. PubMed
  10. Onuma Y, Dudek D, Thuesen L, Webster M, Nieman K, Garcia-Garcia HM, et al. Five-year clinical and functional multislice computed tomography angiographic results after coronary implantation of the fully resorbable polymeric everolimus-eluting scaffold in patients with de novo coronary artery disease: the ABSORB cohort A trial.JACC Cardiovasc Interv. 2013;6(10):999-1009. doi: 10.1016/j.jcin.2013.05.017. PubMed
  11. Onuma Y, Serruys PW, Muramatsu T, Nakatani S, van Geuns RJ, de Bruyne B, et al. Incidence and imaging outcomes of acute scaffold disruption and late structural discontinuity after implantation of the absorb Everolimus-Eluting fully bioresorbable vascular scaffold: optical coherence tomography assessment in the ABSORB cohort B Trial (A Clinical Evaluation of the Bioabsorbable Everolimus Eluting Coronary Stent System in the Treatment of Patients With De Novo Native Coronary Artery Lesions). JACC Cardiovasc Interv. 2014 Dec;7(12):1400-11. doi: 10.1016/j.jcin.2014.06.016. PubMed
  12. Costopoulos C, Latib A, Naganuma T, Miyazaki T, Sato K, Figini F, et al. Comparison of early clinical outcomes between ABSORB bioresorbable vascular scaffold and everolimus-eluting stent implantation in a real-world population. Catheter Cardiovasc Interv. 2015;85(1):E10-5. doi: 10.1002/ccd.25569. Epub 2014 Jul 16. PubMed
  13. Patrick W. Serruys. ABSORB II : A Prospective, Randomized Trial of an Everolimus-Eluting Bioresorbable Scaffold Versus an Everolimus-Eluting Metallic Stent in Patients with Coronary Artery Disease. TCT 2014 13 Sep 2014 - 17 Sep 2014 , Washington, DC - U.S.A. Plenary Session XII : Late-Breaking clinical Trials #2. Available from: https://www.sac.org.ar/wp-content/uploads/2014/09/tct-2014-absorb-ii-a-p...
  14. Moreno R, Fernández C, Hernández R, Alfonso F, Angiolillo DJ, Sabaté M, et al. Drug-eluting stent thrombosis: results from a pooled analysis including 10 randomized studies. J Am Coll Cardiol. 2005 Mar 15;45(6):954-9. PubMed
  15. Grines CL, Bonow RO, Casey DE Jr, Gardner TJ, Lockhart PB, Moliterno DJ, et al. Prevention of premature discontinuation of dual antiplatelet therapy in patients with coronary artery stents: a science advisory from the American Heart Association, American College of Cardiology, Society for Cardiovascular Angiography and Interventions, American College of Surgeons, and American Dental Association, with representation from the American College of Physicians. J Am Coll Cardiol. 2007 Feb 13;49(6):734-9. PubMed
  16. Bhatt DL, Fox KA, Hacke W, Berger PB, Black HR, Boden WE, et al.; CHARISMA Investigators. Clopidogrel and aspirin versus aspirin alone for the prevention of atherothrombotic events. N Engl J Med. 2006 Apr 20;354(16):1706-17. PubMed

Download Article
Received December 30, 2017.
Accepted January 17, 2018.
©2018 International Medical Research and Development Corporation.