title: Bioresorbable vascular scaffold treatment induces the formation of neointimal cap that seals the underlying plaque without compromising the luminal dimensions: a concept based on serial optical coherence tomography data.
abstract: OBJECTIVE
  To evaluate the implications of an Absorb bioresorbable vascular scaffold (Absorb BVS) on the morphology of the superficial plaques.
  
  
  RESULTS
  Forty-six patients who underwent Absorb BVS implantation and 20 patients implanted with bare metal stents (BMS) who had serial optical coherence tomographic examination at baseline and follow-up were included in this analysis. The thin-capped fibroatheromas (TCFA) were identified in the device implantation regions and in the adjacent native coronary segments. Within all regions, circumferential locations of TCFA and calcific tissues were identified, and the neointimal thickness was measured at follow-up. At six to 12-month follow-up, only 8% of the TCFA detected at baseline were still present in the Absorb BVS and 27% in the BMS implantation segment (p=0.231). Sixty percent of the TCFA in native segments did not change their phenotype at follow-up. At short-term follow-up, significant reduction in the lumen area of the BMS was noted, which was higher compared to that reported in the Absorb BVS group (-2.11±1.97 mm2 vs. -1.34±0.99 mm2, p=0.026). In Absorb BVS, neointima tissue continued to develop at midterm follow-up (2.17±0.48 mm2 vs. 1.38±0.52 mm2, p<0.0001) and covered the underlying tissues without compromising the luminal dimensions (5.93±1.49 mm2 vs. 6.14±1.49 mm2, p=0.571) as it was accommodated by the expanded scaffold (8.28±1.74 mm2 vs. 7.67±1.28 mm2, p<0.0001).
  
  
  CONCLUSIONS
  Neointimal tissue develops following either Absorb BVS or BMS implantation and shields lipid tissues. The neointimal response in the BMS causes a higher reduction of luminal dimensions compared to the Absorb BVS. Thus, Absorb BVS may have a value in the invasive re-capping of high-risk plaques.
authors.affiliation: Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands.
authors.forename: Christos V
authors.initials: CV
authors.lastname: Bourantas
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Shimpei
authors.initials: S
authors.lastname: Nakatani
authors.forename: Yao-Jun
authors.initials: YJ
authors.lastname: Zhang
authors.forename: Vasim
authors.initials: V
authors.lastname: Farooq
authors.forename: Roberto
authors.initials: R
authors.lastname: Diletti
authors.forename: Jurgen
authors.initials: J
authors.lastname: Ligthart
authors.forename: Alexander
authors.initials: A
authors.lastname: Sheehy
authors.forename: Robert-Jan M
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Dougal
authors.initials: D
authors.lastname: McClean
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Jacques
authors.initials: J
authors.lastname: Koolen
authors.forename: John
authors.initials: J
authors.lastname: Ormiston
authors.forename: Robert
authors.initials: R
authors.lastname: Whitbourn
authors.forename: Richard
authors.initials: R
authors.lastname: Rapoza
authors.forename: Susan
authors.initials: S
authors.lastname: Veldhof
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D002986:Clinical Trials as Topic; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology*; D005260:Female; D005355:Fibrosis; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D058426:Neointima; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D010641:Phenotype; D058226:Plaque, Atherosclerotic; D011237:Predictive Value of Tests; D011474:Prosthesis Design; D015607:Stents; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D008670:Metals