title: Dynamics of vessel wall changes following the implantation of the absorb everolimus-eluting bioresorbable vascular scaffold: a multi-imaging modality study at 6, 12, 24 and 36 months.
abstract: OBJECTIVE
  To assess observations with multimodality imaging of the Absorb bioresorbable everolimus-eluting vascular scaffold performed in two consecutive cohorts of patients who were serially investigated either at 6 and 24 months or at 12 and 36 months.
  
  
  RESULTS
  In the ABSORB multicentre single-arm trial, 45 patients (cohort B1) and 56 patients (cohort B2) underwent serial invasive imaging, specifically quantitative coronary angiography (QCA), intravascular ultrasound (IVUS), radiofrequency backscattering (IVUS-VH) and optical coherence tomography (OCT). Between one and three years, late luminal loss remained unchanged (6 months: 0.19 mm, 1 year: 0.27 mm, 2 years: 0.27 mm, 3 years: 0.29 mm) and the in-segment angiographic restenosis rate for the entire cohort B (n=101) at three years was 6%. On IVUS, mean lumen, scaffold, plaque and vessel area showed enlargement up to two years. Mean lumen and scaffold area remained stable between two and three years whereas significant reduction in plaque behind the struts occurred with a trend toward adaptive restrictive remodelling of EEM. Hyperechogenicity of the vessel wall, a surrogate of the bioresorption process, decreased from 23.1% to 10.4% with a reduction of radiofrequency backscattering for dense calcium and necrotic core. At three years, the count of strut cores detected on OCT increased significantly, probably reflecting the dismantling of the scaffold; 98% of struts were covered. In the entire cohort B (n=101), the three-year major adverse cardiac event rate was 10.0% without any scaffold thrombosis.
  
  
  CONCLUSIONS
  The current investigation demonstrated the dynamics of vessel wall changes after implantation of a bioresorbable scaffold, resulting at three years in stable luminal dimensions, a low restenosis rate and a low clinical major adverse cardiac events rate.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov/ct2/show/NCT00856856.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.forename: Takashi
authors.initials: T
authors.lastname: Muramatsu
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Bernard
authors.initials: B
authors.lastname: de Bruyne
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
authors.forename: Pieter C
authors.initials: PC
authors.lastname: Smits
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.forename: Dougal
authors.initials: D
authors.lastname: McClean
authors.forename: Jacques
authors.initials: J
authors.lastname: Koolen
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Robert
authors.initials: R
authors.lastname: Whitbourn
authors.forename: Ian
authors.initials: I
authors.lastname: Meredith
authors.forename: Cecile
authors.initials: C
authors.lastname: Dorange
authors.forename: Susan
authors.initials: S
authors.lastname: Veldhof
authors.forename: Karine Miquel
authors.initials: KM
authors.lastname: Hebert
authors.forename: Richard
authors.initials: R
authors.lastname: Rapoza
authors.forename: John A
authors.initials: JA
authors.lastname: Ormiston
mesh_terms: D020341:Absorbable Implants; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation*; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D000068338:Everolimus; D006801:Humans; D064847:Multimodal Imaging / Q000379:methods*; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D054457:Tissue Scaffolds; D041623:Tomography, Optical Coherence; D018084:Ultrasonography, Interventional
chemical_list: D000068338:Everolimus; D020123:Sirolimus