title: Serial in vivo intravascular ultrasound-based echogenicity changes of everolimus-eluting bioresorbable vascular scaffold during the first 12 months after implantation insights from the ABSORB B trial.
abstract: OBJECTIVE
  This study sought to investigate quantitative and homogeneity differential echogenicity changes of the ABSORB scaffold (1.1) during the first year after implantation.
  
  
  BACKGROUND
  The imaging of the ABSORB bioresorbable vascular scaffold degradation by intravascular ultrasound (IVUS) has previously demonstrated diminishing gray-level intensity of the struts over time that can be evaluated by IVUS-based differential echogenicity. The first generation of ABSORB (1.0) showed a 50% reduction in hyperechogenicity at 6 months and restoration of the pre-ABSORB implantation values at 2 years. The second generation of ABSORB (1.1), investigated in the ABSORB B trial, was modified to prolong the duration of luminal scaffolding.
  
  
  METHODS
  A total of 63 patients were examined by IVUS immediately post-implantation and at 6-month (Cohort B1, n = 28) or 12-month (Cohort B2, n = 35) follow-up. IVUS-based tissue composition analysis software was used to quantify changes in hyperechogenicity over time in the scaffolded regions. Relative changes in hyperechogenicity were calculated as: 100 × (% hyperechogenicity at follow-up - % hyperechogenicity at baseline)/% hyperechogenicity at baseline.
  
  
  RESULTS
  At 6- and 12-month follow-up, there was a 15% (from 22.58 ± 9.77% to 17.42 ± 6.69%, p = 0.001) and 20% (from 23.51 ± 8.57% to 18.25 ± 7.19%, p < 0.001) reduction in hyperechogenicity, respectively, compared with post-implantation values. No difference in hyperechogenicity changes were observed between the proximal, medial, or distal part of the scaffolded segment.
  
  
  CONCLUSIONS
  Quantitative differential echogenicity changes of the ABSORB scaffold (1.1) during the first 12 months after implantation are lower compared with those previously observed with its first generation (1.0), confirming the value of the manufacturing changes and suggesting a slower degradation rate of the scaffold.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.forename: Josep
authors.initials: J
authors.lastname: Gomez-Lara
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Vasim
authors.initials: V
authors.lastname: Farooq
authors.forename: Robert Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
authors.forename: Jacques
authors.initials: J
authors.lastname: Koolen
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.forename: Dougal
authors.initials: D
authors.lastname: McClean
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Smits
authors.forename: Bernard
authors.initials: B
authors.lastname: de Bruyne
authors.forename: Robert
authors.initials: R
authors.lastname: Whitbourn
authors.forename: Ian
authors.initials: I
authors.lastname: Meredith
authors.forename: Ron T
authors.initials: RT
authors.lastname: van Domburg
authors.forename: Kenij
authors.initials: K
authors.lastname: Sihan
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: de Winter
authors.forename: Susan
authors.initials: S
authors.lastname: Veldhof
authors.forename: Karine
authors.initials: K
authors.lastname: Miquel-Hebert
authors.forename: Richard
authors.initials: R
authors.lastname: Rapoza
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.forename: John A
authors.initials: JA
authors.lastname: Ormiston
authors.forename: Nico
authors.initials: N
authors.lastname: Bruining
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; 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; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D002317:Cardiovascular Agents; D008670:Metals; D000068338:Everolimus; D020123:Sirolimus