title: Procedural feasibility and clinical outcomes in propensity-matched patients treated with bioresorbable scaffolds vs new-generation drug-eluting stents.
abstract: BACKGROUND
  There is limited experience regarding the feasibility of the bioresorbable vascular scaffold (BVS) in "all-comer" populations. We evaluated the impact of BVS use on procedural factors and clinical outcomes compared with the new-generation drug-eluting stent (DES).
  
  
  METHODS
  We analyzed procedural feasibility and outcome data from 292 consecutive patients treated with either a new-generation DES or a BVS between May 2008 and May 2014 using propensity-score (PS) matching.
  
  
  RESULTS
  After PS matching, 96 patients treated with BVSs and 96 patients treated with DESs were selected. Lesion characteristics were similar between the 2 groups. Maximum balloon size after dilation was larger and maximum inflation pressure was higher in the BVS group, despite similar quantitative coronary angiography results. Procedure time (114.7 ± 39.2 minutes vs 90.4 ± 38.2 minutes; P < 0.001), amount of contrast medium used (268.3 ± 104.2 mL vs 229.2 ± 122.2 mL; P = 0.02), and fluoroscopy time (42.4 ± 17.9 minutes vs 34.5 ± 19.7 minutes; P < 0.001) were significantly increased in the BVS group compared with the DES group. In multivariable analysis, BVS use was identified as an independent predictor of long (> 120 minutes) procedure time (odds ratio, 7.83; 95% confidence interval, 2.81-25.78; P < 0.001). Procedural success (93.6% BVS vs 95.7% DES; P = 0.51) and 1-year major adverse cardiovascular events (10.2% BVS vs 10.5% DES; P = 0.82) were similar between the groups.
  
  
  CONCLUSIONS
  In real-world patients with predominantly complex lesions treated with BVSs, procedural success rates and short-term outcomes similar to those seen in patients treated with DESs are observed at the expense of longer procedure and fluoroscopy times.
authors: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors: Katsumasa
authors: K
authors: Sato
authors: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors: Azeem
authors: A
authors: Latib
authors: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy; Imperial College London, National Heart and Lung Institute, London, United Kingdom.
authors: Vasileios F
authors: VF
authors: Panoulas
authors: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors: Hiroyoshi
authors: H
authors: Kawamoto
authors: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors: Toru
authors: T
authors: Naganuma
authors: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy.
authors: Tadashi
authors: T
authors: Miyazaki
authors: Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy. Electronic address: info@emocolumbus.it.
authors: Antonio
authors: A
authors: Colombo
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D054059:Coronary Occlusion / Q000628:therapy; D054855:Drug-Eluting Stents; D000068338:Everolimus; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D011474:Prosthesis Design; D015203:Reproducibility of Results; D012189:Retrospective Studies; D020123:Sirolimus / Q000031:analogs & derivatives; D054457:Tissue Scaffolds; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus; D020123:Sirolimus