title: Assessment of plaque evolution in coronary bifurcations located beyond everolimus eluting scaffolds: serial intravascular ultrasound virtual histology study.
abstract: OBJECTIVE
  To evaluate the atherosclerotic evolution in coronary bifurcations located proximally and distally to a bioresorbable scaffold.
  
  
  METHODS
  Thirty bifurcations located >5 mm beyond the scaffolded segment, being investigated with serial intravascular ultrasound virtual histology (IVUS-VH) examinations, at baseline and 2-years, in patients enrolled in the ABSORB cohort B1 study were included in this analysis. In each bifurcation, the frames portraying the proximal rim, in-bifurcation, and distal rim of the ostium of the side branch were analyzed. The geometric parameters and plaque types were evaluated at baseline and 2-years follow-up.
  
  
  RESULTS
  There were no significant differences in the geometrical parameters such as lumen, vessel and plaque areas as well as in the composition of the atheroma between baseline and 2-years follow-up.When we separately examined the bifurcations located proximally and distally to the scaffolded segment, no changes were found at the distal bifurcations, while at the proximal bifurcations there was a statistical significant decrease in the plaque burden (36.67 ± 13.33% at baseline vs. 35.06 ± 13.20% at 2 years follow-up, p = 0.04).Ten necrotic core rich plaques were found at baseline, of which 2 regressed to either fibrotic plaque or to intimal thickening at 2 years follow-up. The other 8 did not change. Disease progression was noted in 3 plaques (1 adaptive intimal thickening, 1 fibrotic and 1 fibrocalcific plaque) that evolved to necrotic rich plaques.
  
  
  CONCLUSIONS
  Plaque regression was noted at the bifurcations located proximally to the bioresorbable scaffold but not at these located distally. Additional studies are required to confirm this finding and examine further the effect of drug elution on atherosclerotic evolution.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Il Soo
authors.initials: IS
authors.lastname: Lee
authors.forename: Christos V
authors.initials: CV
authors.lastname: Bourantas
authors.forename: Takashi
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Bill D
authors.initials: BD
authors.lastname: Gogas
authors.forename: Jung Ho
authors.initials: JH
authors.lastname: Heo
authors.forename: Roberto
authors.initials: R
authors.lastname: Diletti
authors.forename: Vasim
authors.initials: V
authors.lastname: Farooq
authors.forename: Yaojun
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D023921:Coronary Stenosis; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D054855:Drug-Eluting Stents; D004452:Echocardiography / Q000379:methods*; D000068338:Everolimus; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013382:Subtraction Technique; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000379:methods*; D014584:User-Computer Interface
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus