title: Analysis of 1 year virtual histology changes in coronary plaque located behind the struts of the everolimus eluting bioresorbable vascular scaffold.
abstract: Serial intravascular ultrasound virtual histology (IVUS-VH) after implantation of metallic stents has been unable to show any changes in the composition of the scaffolded plaque overtime. The everolimus-eluting ABSORB scaffold potentially allows for the formation of new fibrotic tissue on the scaffolded coronary plaque during bioresorption. We examined the 12 month IVUS-VH changes in composition of the plaque behind the struts (PBS) following the implantation of the ABSORB scaffold. Using IVUS-VH and dedicated software, the composition of the PBS was analyzed in all patients from the ABSORB Cohort B2 trial, who were imaged with a commercially available IVUS-VH console (s5i system, Volcano Corporation, Rancho Cordova, CA, USA), immediately post-ABSORB implantation and at 12 month follow-up. Paired IVUS-VH data, recorded with s5i system, were available in 17 patients (18 lesions). The analysis demonstrated an increase in mean PBS area (2.39 ± 1.85 mm(2) vs. 2.76 ± 1.79 mm(2), P = 0.078) and a reduction in the mean lumen area (6.37 ± 0.90 mm(2) vs. 5.98 ± 0.97 mm(2), P = 0.006). Conversely, a significant decrease of 16 and 30% in necrotic core (NC) and dense calcium (DC) content, respectively, were evident (median % NC from 43.24 to 36.06%, P = 0.016; median % DC from 20.28 to 11.36%, P = 0.002). Serial IVUS-VH analyses of plaque located behind the ABSORB struts at 12-month demonstrated an increase in plaque area with a decrease in its NC and DC content. Larger studies are required to investigate the clinical impact of these findings.
authors: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, 's Gravendijkwal 230, 3015, Rotterdam, CE, The Netherlands.
authors: Salvatore
authors: S
authors: Brugaletta
authors: Josep
authors: J
authors: Gomez-Lara
authors: Hector M
authors: HM
authors: Garcia-Garcia
authors: Jung Ho
authors: JH
authors: Heo
authors: Vasim
authors: V
authors: Farooq
authors: Robert J
authors: RJ
authors: van Geuns
authors: Bernard
authors: B
authors: Chevalier
authors: Stephan
authors: S
authors: Windecker
authors: Dougal
authors: D
authors: McClean
authors: Leif
authors: L
authors: Thuesen
authors: Robert
authors: R
authors: Whitbourn
authors: Ian
authors: I
authors: Meredith
authors: Cecile
authors: C
authors: Dorange
authors: Susan
authors: S
authors: Veldhof
authors: Richard
authors: R
authors: Rapoza
authors: John A
authors: JA
authors: Ormiston
authors: Patrick W
authors: PW
authors: Serruys
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D001315:Australia; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology; D005060:Europe; D000068338:Everolimus; D005260:Female; D005355:Fibrosis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis; D009520:New Zealand; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D054457:Tissue Scaffolds; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D002317:Cardiovascular Agents; D000068338:Everolimus; D020123:Sirolimus