6533b857fe1ef96bd12b3bc8

RESEARCH PRODUCT

Early and midterm outcomes of bioresorbable vascular scaffolds for ostial coronary lesions: insights from the GHOST-EU registry.

Christoph NaberDavide CapodannoAleksander AraszkiewiczCarlo Di MarioCorrado TamburinoThomas MünzelAlessio MattesiniGiuseppe CaramannoAzeem LatibTommaso GoriJens WiebeSalvatore GeraciStylianos A. PyxarasPiera CapranzanoJulinda MehilliAntonio ColomboMaciej LesiakHolger NefManel SabatéSalvatore BrugalettaJulia Weber

subject

LCX (29Target lesionMale52%). Patients presenting with ostial lesions did not differ from the remaining cohort except for a higher incidence of prior revascularisation. Predilation was performed in 97% of the lesions (vs. 96% in non-ostialp= 0.035)medicine.medical_treatmentMyocardial Infarction304 patients with a mean age of 62 +/- 11years. There were 90 ostial lesions (5.8%) in 84 patients (6.4%) located at the ostial RCA (14Coronary Artery Disease030204 cardiovascular system & hematologyCoronary artery diseasebut their safety in this setting remains to be explored. Methods and results: Procedural and 12-month follow-up data from consecutive patients treated with BVS for lesions located at the ostium of the right (RCA)0302 clinical medicineAbsorbable Implants030212 general & internal medicineMyocardial infarctionCircumflexRegistriesTissue Scaffolds32%)Drug-Eluting StentsMiddle AgedThrombosisCoronary VesselsAims: We aimed to investigate the outcomes of bioresorbable vascular scaffolds (BVS) in coronary ostial lesions. Ostial lesions represent a challenging angiographic subset with higher event rates compared with non-ostial lesions. BVS might be associated with advantages over the long term but their safety in this setting remains to be explored. Methods and results: Procedural and 12-month follow-up data from consecutive patients treated with BVS for lesions located at the ostium of the right (RCA) left anterior (LAD) or circumflex (LCX) coronary in 11 European centres were collected. The primary device-oriented endpoint was defined as a combination of cardiovascular death target vessel myocardial infarction or target lesion revascularisation. The database included a total of 1549 lesions in 1304 patients with a mean age of 62 +/- 11years. There were 90 ostial lesions (5.8%) in 84 patients (6.4%) located at the ostial RCA (14; 16%) LCX (29; 32%) or LAD (47; 52%). Patients presenting with ostial lesions did not differ from the remaining cohort except for a higher incidence of prior revascularisation. Predilation was performed in 97% of the lesions (vs. 96% in non-ostial p= 0.618) post-dilation in 43% (versus 58% in the non-ostial group p= 0.008). At quantitative coronary angiography treatment of ostial lesions was associated with higher residual stenosis (30% [23-41] vs. 26% [20-37] p= 0.035) but no difference in minimum lumen diameter existed (p= 0.447). Follow-up data were available at 385 [362-465] days. The 12-month Kaplan-Meier estimated rates of scaffold thrombosis were 4.9% and 2.0% (ostial and non-ostial lesion groups respectively log-rank p= 0.005). The device-oriented composite endpoint occurred respectively in 12.6% and 4.6% at 12 months (log-rank p= 0.001). Treatment of ostial lesions was an independent predictor of this endpoint (p= 0.0025 HR 2.65 [1.41-4.97]).OstiumAims: We aimed to investigate the outcomes of bioresorbable vascular scaffolds (BVS) in coronary ostial lesions. Ostial lesions represent a challenging angiographic subsetTreatment Outcomein 12.6% and 4.6% at 12 months (log-rank p= 0.001). Treatment of ostial lesions was an independent predictor of this endpoint (p= 0.0025CardiologyFemale549 lesions in 1medicine.symptomCardiology and Cardiovascular MedicineAdultpost-dilation in 43% (versus 58% in the non-ostial groupmedicine.medical_specialtyor LAD (47HR 2.65 [1.41-4.97])but no difference in minimum lumen diameter existed (p= 0.447). Follow-up data were available at 385 [362-465] days. The 12-month Kaplan-Meier estimated rates of scaffold thrombosis were 4.9% and 2.0% (ostial and non-ostial lesion groupsrespectivelyLesion03 medical and health sciencesPercutaneous Coronary Interventionwith higher event rates compared with non-ostial lesions. BVS might be associated with advantages over the long termleft anterior (LAD) or circumflex (LCX) coronary in 11 European centres were collected. The primary device-oriented endpoint was defined as a combination of cardiovascular deathInternal medicinemedicineHumanstarget vessel myocardial infarction or target lesion revascularisation. The database included a total of 1Agedp= 0.008). At quantitative coronary angiographybusiness.industryPercutaneous coronary interventionp= 0.618)treatment of ostial lesions was associated with higher residual stenosis (30% [23-41] vs. 26% [20-37]log-rank p= 0.005). The device-oriented composite endpoint occurredmedicine.diseaseSurgery16%)business

description

Aims: We aimed to investigate the outcomes of bioresorbable vascular scaffolds (BVS) in coronary ostial lesions. Ostial lesions represent a challenging angiographic subset, with higher event rates compared with non-ostial lesions. BVS might be associated with advantages over the long term, but their safety in this setting remains to be explored. Methods and results: Procedural and 12-month follow-up data from consecutive patients treated with BVS for lesions located at the ostium of the right (RCA), left anterior (LAD) or circumflex (LCX) coronary in 11 European centres were collected. The primary device-oriented endpoint was defined as a combination of cardiovascular death, target vessel myocardial infarction or target lesion revascularisation. The database included a total of 1,549 lesions in 1,304 patients with a mean age of 62 +/- 11years. There were 90 ostial lesions (5.8%) in 84 patients (6.4%) located at the ostial RCA (14;16%), LCX (29;32%), or LAD (47;52%). Patients presenting with ostial lesions did not differ from the remaining cohort except for a higher incidence of prior revascularisation. Predilation was performed in 97% of the lesions (vs. 96% in non-ostial, p= 0.618), post-dilation in 43% (versus 58% in the non-ostial group, p= 0.008). At quantitative coronary angiography, treatment of ostial lesions was associated with higher residual stenosis (30% [23-41] vs. 26% [20-37], p= 0.035), but no difference in minimum lumen diameter existed (p= 0.447). Follow-up data were available at 385 [362-465] days. The 12-month Kaplan-Meier estimated rates of scaffold thrombosis were 4.9% and 2.0% (ostial and non-ostial lesion groups, respectively, log-rank p= 0.005). The device-oriented composite endpoint occurred, respectively, in 12.6% and 4.6% at 12 months (log-rank p= 0.001). Treatment of ostial lesions was an independent predictor of this endpoint (p= 0.0025, HR 2.65 [1.41-4.97]). Conclusions: In combination with a suboptimal implantation technique, treatment of coronary ostial lesions was an independent predictor of clinical events in a cohort of patients treated with BVS.

yearjournalcountryeditionlanguage
2016-01-01EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
10.4244/eijy15m09_10https://pubmed.ncbi.nlm.nih.gov/26348681