title: Morphological and functional evaluation of the bioresorption of the bioresorbable everolimus-eluting vascular scaffold using IVUS, echogenicity and vasomotion testing at two year follow-up: a patient level insight into the ABSORB A clinical trial.
abstract: The aim of this study was to describe vaso-reactivity (by Acetylcholine and Methergine tests) at 2 year follow-up in parallel with the individual changes in the echogenicity characteristics of the polymer struts of the everolimus eluting bioresorbable vascular scaffold (BVS), from post-treatment to 2 year follow-up, in patients enrolled in the ABSORB Cohort A study. Intravascular ultrasound assessment was performed with a phased array catheter (EagleEye, Volcano Corporation, Cordova, CA, USA) with automated pullback at 0.5 mm per second. The % ratio at 6 months and 2 years [(Scaffold Area post PCI- Lumen Area)/Scaffold Area post PCI] was calculated as a measure of scaffold shrinkage. The % change of hyperechogenicity was defined as: ([post-procedural hyperechogenicity] - [2 year follow up hyperechogenicity])/[post-procedural hyperechogenicity]) × 100. The vasomotion test with intracoronary acetylcholine (10(-6) M) or intravenous methergine (0.4 mg) was performed at 2 years. Overall nine patients received all these analyses and were enrolled in the present analysis. A 50-96% reduction in hyperechogenicity was observed between baseline and 2 years, which corresponded to a change in vasoreactivity between 2 and 22%. A vasoconstriction of the scaffolded segment was observed in the 5 patients, who underwent the methergine test, with a mean decrease in lumen diameter after methergine of 9 ± 7% (P = 0.06), while vasodilatation occurred in the 4 patients who underwent the acetylcholine test with a mean increase in lumen diameter after acetylcholine of 8 ± 5% (P = 0.125). Bioresorption of the BVS is accompanied by re-establishment of both endothelial and non-endothelial dependent vasomotion.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Bd583a, Dr. Molewaterplein 40, 3015-GD, Rotterdam, The Netherlands.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Sarno
authors.forename: Nico
authors.initials: N
authors.lastname: Bruining
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Scot
authors.initials: S
authors.lastname: Garg
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: De Winter
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
authors.forename: Susan
authors.initials: S
authors.lastname: Veldhof
authors.forename: Cecile
authors.initials: C
authors.lastname: Dorange
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.forename: John A
authors.initials: JA
authors.lastname: Ormiston
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation; D002317:Cardiovascular Agents / Q000008:administration & dosage; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D014664:Vasodilation / Q000187:drug effects*
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus; D020123:Sirolimus