title: Vascular compliance changes of the coronary vessel wall after bioresorbable vascular scaffold implantation in the treated and adjacent segments.
abstract: BACKGROUND
  Implantation of a metallic prosthesis creates local stiffness with a subsequent mismatch in the compliance of the vessel wall, disturbances in flow and heterogeneous distribution of wall shear stress. Polymeric bioresorbable ABSORB scaffolds have less stiffness than metallic platform stents. We sought to analyze the mismatch in vascular compliance after ABSORB implantation and its long-term resolution with bioresorption.
  
  
  RESULTS
  A total of 83 patients from the ABSORB trials underwent palpography investigations (30 and 53 patients from ABSORB Cohorts A and B, respectively) to measure the compliance of the scaffolded and adjacent segments at various time points (from pre-implantation up to 24 months). The mean of the maximum strain values was calculated per segment by utilizing the Rotterdam Classification (ROC) score and expressed as ROC/mm. Scaffold implantation lead to a significant decrease in vascular compliance (median [IQR]) at the scaffolded segment (from 0.37 [0.24-0.45] to 0.14 [0.09-0.23], P<0.001) with mismatch in compliance in a paired analysis between the scaffolded and adjacent segments (proximal: 0.23 [0.12-0.34], scaffold: 0.12 [0.07-0.19], distal: 0.15 [0.05-0.26], P=0.042). This reported compliance mismatch disappears at short- and mid-term follow-up.
  
  
  CONCLUSIONS
  The ABSORB scaffold decreases vascular compliance at the site of scaffold implantation. A compliance mismatch is evident immediately post-implantation and in contrast to metallic stents disappears in the mid-term, likely leading to a normalization of the rheological behavior of the scaffolded segment.
authors.affiliation: Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.forename: Bill D
authors.initials: BD
authors.lastname: Gogas
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.forename: Vasim
authors.initials: V
authors.lastname: Farooq
authors.forename: Chrysafios
authors.initials: C
authors.lastname: Girasis
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Heo
authors.forename: Robert Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Bernard
authors.initials: B
authors.lastname: de Bruyne
authors.forename: Dariuz
authors.initials: D
authors.lastname: Dudek
authors.forename: Jacques
authors.initials: J
authors.lastname: Koolen
authors.forename: Pieter
authors.initials: P
authors.lastname: Smits
authors.forename: Susan
authors.initials: S
authors.lastname: Veldhof
authors.forename: Richard
authors.initials: R
authors.lastname: Rapoza
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: John
authors.initials: J
authors.lastname: Ormiston
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*; D001696:Biomechanical Phenomena; D002317:Cardiovascular Agents / Q000008:administration & dosage; D003187:Compliance; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000503:physiopathology*; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011091:Polyesters / Q000737:chemistry*; 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; D011091:Polyesters; C033616:poly(lactide); D000068338:Everolimus; D020123:Sirolimus