title: Impact of post-dilation on the acute and one-year clinical outcomes of a large cohort of patients treated solely with the Absorb Bioresorbable Vascular Scaffold.
abstract: OBJECTIVE
  We sought to determine the impact of post-dilation (PD) on clinical outcomes in a large cohort of patients treated only with the Absorb Bioresorbable Vascular Scaffold (BVS).
  
  
  RESULTS
  We evaluated all consecutive patients enrolled in the multicentre, single-arm ABSORB EXTEND study up to June 2013. The study allowed treatment of up to two coronaries (diameter 2.0 to 3.8 mm) and the use of overlapping (lesion length ≤28 mm). Patients with severe lesion calcification/tortuosity were excluded. Aggressive lesion predilation (balloon to artery ratio of 0.9-1.0) was mandatory, and PD was left to the operator's discretion. Patients were grouped according to whether PD was performed or not, and the one-year incidences of MACE and scaffold thrombosis were compared. A total of 768 patients were enrolled in the study; PD was performed in 526 (68.4%). There were no significant differences between the PD group and non-PD group in the majority of baseline characteristics, including the presence of moderate calcification and of B2/C lesions. Lesion length was similar (12.3±5.1 mm vs. 12.1±5.3 mm, p=0.6), as was RVD (2.6 mm for both groups, p=0.2). Residual in-scaffold stenosis (15.5±6.4% with PD, 15.0±6% without PD, p=0.3) and the need for bail-out scaffold/stent (4.2% with PD, 4.6% without PD, p=0.8) were comparable. Acute gain was higher in the non-PD group (1.14±0.3 mm vs. 1.21±0.4 mm, p=0.02). Clinical device success was 98.9% in both groups. At one year, there was no difference in MACE (5.4% in the PD group vs. 2.5% in the non-PD group, p=0.1). All individual components of TLR, death, and MI were similar as well as definite/probable scaffold thrombosis between the two groups.
  
  
  CONCLUSIONS
  These results reflect very similar final angiographic and clinical results achieved with or without post-dilation in the treatment of low to moderately complex coronary lesions. Therefore, post-dilation should be performed whenever needed to optimise acute results.
authors.affiliation: Instituto de Cardiologia Dante Pazzanese, São Paulo, Brazil.
authors.forename: José
authors.initials: J
authors.lastname: De Ribamar Costa
authors.forename: Alexandre
authors.initials: A
authors.lastname: Abizaid
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Bartorelli
authors.forename: Robert
authors.initials: R
authors.lastname: Whitbourn
authors.forename: Robert Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.forename: Marcos
authors.initials: M
authors.lastname: Perin
authors.forename: Ashok
authors.initials: A
authors.lastname: Seth
authors.forename: Roberto
authors.initials: R
authors.lastname: Botelho
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects; D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D015331:Cohort Studies; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000628:therapy*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents