title: Bioresorbable vascular scaffold thrombosis in an all-comer patient population: single-center experience.
abstract: Experience with bioresorbable vascular scaffolds (BVSs) outside clinical trials is scarce, and data from "real-world" use are needed. In particular, there are few data on scaffold thrombosis (ST). We report our experience with ST in our all-comer BVS population (n = 339) and review the literature on the topic. Four cases (1.2%) of early definite ST were identified. Multiple risk factors were present in all 4 cases. Optical coherence tomography ruled out mechanical causes of ST in 2 cases, whereas scaffold underexpansion was observed in 1 case. Twelve BVS series have been published to date. Total sample size includes 1393 patients, with 13 cases of definite ST (0.9%), which is similar to long-term second-generation drug-eluting stent thrombosis rate (1.0%). Eleven of these cases were early ST (8 during the first week). Six of these 11 cases occurred in patients who received a BVS in the setting of an acute coronary syndrome (ACS). It can be speculated that the prothrombotic milieu of ACS, coupled with the unfavorable peristrut rheology of BVSs, might promote ST early after implantation, particularly if other concomitant risk factors are present.
authors: Desgroseillers-Bérard Chair in Interventional Cardiology, University of Montreal, Director, Interventional Cardiology, Department of Medicine, Montreal Heart Institute, 5000 Bélanger Est - Montréal, Québec, H1T 1C8 Canada. philippe.lallier@icm-mhi.org.
authors: Lorenzo
authors: L
authors: Azzalini
authors: Philippe L
authors: PL
authors: L'Allier
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects*; D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D000068338:Everolimus / Q000494:pharmacology; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D011474:Prosthesis Design; D012086:Reoperation; D012189:Retrospective Studies; D020123:Sirolimus / Q000494:pharmacology; D054457:Tissue Scaffolds / Q000009:adverse effects*; D041623:Tomography, Optical Coherence
chemical_list: D000068338:Everolimus; D020123:Sirolimus