title: OCT assessment of the long-term vascular healing response 5 years after everolimus-eluting bioresorbable vascular scaffold.
abstract: BACKGROUND
  Although recent observations suggest a favorable initial healing process of the everolimus-eluting bioresorbable vascular scaffold (BVS), little is known regarding long-term healing response.
  
  
  OBJECTIVE
  This study assessed the in vivo vascular healing response using optical coherence tomography (OCT) 5 years after elective first-in-man BVS implantation.
  
  
  METHODS
  Of the 14 living patients enrolled in the Thoraxcenter Rotterdam cohort of the ABSORB A study, 8 patients underwent invasive follow-up, including OCT, 5 years after implantation. Advanced OCT image analysis included luminal morphometry, assessment of the adluminal signal-rich layer separating the lumen from other plaque components, visual and quantitative tissue characterization, and assessment of side-branch ostia "jailed" at baseline.
  
  
  RESULTS
  In all patients, BVS struts were integrated in the vessel and were not discernible. Both minimum and mean luminal area increased from 2 to 5 years, whereas lumen eccentricity decreased over time. In most patients, plaques were covered by a signal-rich, low-attenuating layer. Minimum cap thickness over necrotic core was 155 ± 90 μm. One patient showed plaque progression and discontinuity of this layer. Side-branch ostia were preserved with tissue bridge thinning that had developed in the place of side-branch struts, creating a neo-carina.
  
  
  CONCLUSIONS
  At long-term BVS follow-up, we observed a favorable tissue response, with late luminal enlargement, side-branch patency, and development of a signal-rich, low-attenuating tissue layer that covered thrombogenic plaque components. The small size of the study and the observation of a different tissue response in 1 patient warrant judicious interpretation of our results and confirmation in larger studies.
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Antonios
authors.initials: A
authors.lastname: Karanasos
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Cihan
authors.initials: C
authors.lastname: Simsek
authors.affiliation: Department of Biomedical Engineering, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Muthukarrupan
authors.initials: M
authors.lastname: Gnanadesigan
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Nienke S
authors.initials: NS
authors.lastname: van Ditzhuijzen
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Raphael
authors.initials: R
authors.lastname: Freire
authors.affiliation: Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jouke
authors.initials: J
authors.lastname: Dijkstra
authors.affiliation: Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Shengxian
authors.initials: S
authors.lastname: Tu
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Van Mieghem
authors.affiliation: Department of Biomedical Engineering, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Gijs
authors.initials: G
authors.lastname: van Soest
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: de Jaegere
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Robert-Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus University Medical Center, Rotterdam, the Netherlands. Electronic address: e.regar@erasmusmc.nl.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
mesh_terms: D020341:Absorbable Implants / Q000639:trends*; D015331:Cohort Studies; D054855:Drug-Eluting Stents / Q000639:trends*; D000068338:Everolimus; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009426:Netherlands; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D013997:Time Factors; D054457:Tissue Scaffolds / Q000639:trends*; D041623:Tomography, Optical Coherence / Q000379:methods / Q000639:trends*; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects / Q000502:physiology*
chemical_list: D000068338:Everolimus; D020123:Sirolimus
keywords: percutaneous coronary intervention; plaque; stents