title: Head-to-head comparison of the neointimal response between metallic and bioresorbable everolimus-eluting scaffolds using optical coherence tomography.
abstract: OBJECTIVE
  This study sought to compare the neointimal response of metallic everolimus drug-eluting stents (DES) and polymeric everolimus bioresorbable vascular scaffolds (BVS) by optical coherence tomography at 1 year.
  
  
  BACKGROUND
  DES decrease the risk of restenosis by reducing the neointimal response. However, DES may impair strut coverage, and this has been associated with late stent/scaffold thrombosis. BVS may overcome the risk of stent/scaffold thrombosis when completely resorbed. It is unknown if, during the bioresorption process, the neointimal response of the everolimus BVS (Absorb, Abbott Vascular, Santa Clara, California) differs from that of the metallic everolimus DES (Xience, Abbott Vascular).
  
  
  METHODS
  A total of 19 lesions were treated with a single everolimus DES, and 31 lesions were treated with everolimus BVS and imaged with optical coherence tomography at 1 year. Neointimal response was assessed as percentage of uncovered struts, neointimal thickness, in-stent/scaffold area obstruction, and pattern of neointima.
  
  
  RESULTS
  At 1 year, no significant differences in the angiographic lumen loss were seen for the everolimus DES and everolimus BVS (0.18 ± 0.20 mm vs. 0.29 ± 0.36 mm; p = 0.42). optical coherence tomography analysis of 951 cross sections and 8,385 struts demonstrated similar rates of uncovered struts (5.3% everolimus DES vs. 4.5% everolimus BVS; p = 0.11), mean neointimal thickness (120.6 ± 46.0 μm vs. 136.1 ± 71.4 μm; p = 0.82) and in-stent/scaffold area obstruction (12.5 ± 7.1% vs. 13.6 ± 9.7%; p = 0.91), respectively. There was a trend of higher heterogenic tissue pattern of neointima (21.1% vs. 6.5%; p = 0.12) and less intraluminal masses (0% vs. 12.9%; p = 0.10) with everolimus DES than with everolimus BVS.
  
  
  CONCLUSIONS
  The everolimus BVS (Absorb) demonstrated a similar neointimal response as the everolimus DES (Xience). However, the presence of intraluminal masses at 12 months in a small proportion of patients warranted watchful follow-up of these cases.
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Josep
authors.initials: J
authors.lastname: Gomez-Lara
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.forename: Vasim
authors.initials: V
authors.lastname: Farooq
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Roberto
authors.initials: R
authors.lastname: Diletti
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
authors.forename: Dougal
authors.initials: D
authors.lastname: McClean
authors.forename: Jacques
authors.initials: J
authors.lastname: Koolen
authors.forename: Robert
authors.initials: R
authors.lastname: Whitbourn
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Smits
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.forename: Susan
authors.initials: S
authors.lastname: Veldhof
authors.forename: Richard
authors.initials: R
authors.lastname: Rapoza
authors.forename: John A
authors.initials: JA
authors.lastname: Ormiston
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D023921:Coronary Stenosis / Q000175:diagnosis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D003331:Coronary Vessels / Q000473:pathology*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D017539:Tunica Intima / Q000473:pathology*
chemical_list: D002317:Cardiovascular Agents; D008670:Metals; D000068338:Everolimus; D020123:Sirolimus