Late stent recoil of the bioabsorbable everolimus-eluting coronary stent and its relationship with plaque morphology.
OBJECTIVE
This study sought to evaluate late recoil of a novel bioabsorbable everolimus-eluting coronary stent (BVS), which is composed of a poly-L-lactic acid backbone, coated with a bioabsorbable polymer containing everolimus.


BACKGROUND
Little is known about the mechanical behavior of bioabsorbable polymer stents after deployment in diseased human coronary arteries.


METHODS
The study population consisted of 16 patients, who were treated with elective BVS implantation for single de novo native coronary artery lesions and were followed at 6 months. All patients underwent an intravascular ultrasound examination at post-procedure and follow-up. A total of 484 paired cross-sectional areas (CSAs) were acquired and analyzed. Late absolute stent recoil was defined as stent area at post-procedure (X) - stent area at follow-up (Y). Late percent stent recoil was defined as (X - Y)/X x 100. In each CSA, plaque morphology was assessed qualitatively and classified as calcific, fibronecrotic, or fibrocellular plaque.


RESULTS
Late absolute and percent recoil of the BVS was 0.65 +/- 1.71 mm(2) (95% confidence interval [CI]: 0.49 to 0.80 mm(2)) and 7.60 +/- 23.3% (95% CI: 5.52% to 9.68%). Calcified plaques resulted in significantly less late recoil (0.20 +/- 1.54 mm(2) and 1.97 +/- 22.2%) than fibronecrotic plaques (1.03 +/- 2.12 mm(2) and 12.4 +/- 28.0%, p = 0.001 and p = 0.001, respectively) or fibrocellular plaque (0.74 +/- 1.48 mm(2) and 8.90 +/- 19.8%, p = 0.001 and p = 0.001, respectively).


CONCLUSIONS
The BVS shrank in size during the follow-up period. The lesion morphology of stented segments might affect the degree of late recoil of the BVS. (ABSORB Everolimus Eluting Coronary Stent System First in Man Clinical Investigation; NCT00300131).
Tanimoto
Shuzou
S
Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.
Bruining
Nico
N
van Domburg
Ron T
RT
Rotger
David
D
Radeva
Petia
P
Ligthart
Jurgen M
JM
Serruys
Patrick W
PW
D000368:Aged; D001672:Biocompatible Materials / Q000737:chemistry; D003324:Coronary Artery Disease / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D019344:Lactic Acid / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D011091:Polyesters; D011108:Polymers / Q000737:chemistry; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D013997:Time Factors
D001672:Biocompatible Materials; D007166:Immunosuppressive Agents; D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide); D000068338:Everolimus; D020123:Sirolimus