title: Coronary Artery Vessel Healing Pattern, Short and Long Term, After Implantation of the Everolimus-Eluting Bioresorbable Vascular Scaffold.
abstract: BACKGROUND
  Although the Absorb bioresorbable vascular scaffold is increasingly used in daily clinical practice for the treatment of coronary artery disease, the exact vascular healing pattern and the resorption process in humans is unknown because histological data are derived only from animal studies.
  
  
  RESULTS
  We have obtained 4 autopsies (5 scaffolds) since August 2013. Duration of bioresorbable vascular scaffold implantation ranged from 3 to 501 days. All autopsies and histological assessments were performed by dedicated cardiovascular pathologists. At 1 week after bioresorbable vascular scaffold implantation, struts were covered with a fine layer of fibrin and platelets. At 113 days, the scaffold struts were fully covered with smooth muscle cells. Hyaline eosinophilic and proteoglycan material infiltrating the scaffold struts was observed at 501 days after implantation. At all time points, we observed the presence of multinuclear foreign body giant cells adjacent to the scaffold struts.
  
  
  CONCLUSIONS
  Resorption and healing processes after bioresorbable vascular scaffold implantation in human patients mirror those observed in porcine models. The presence of multinucleated foreign body giant cells at both short- and long-term follow-up needs further investigation and may be related to a low-grade absorptive inflammatory response to the polymer.
authors.affiliation: AMC Heartcenter, Academic Medical Center - University of Amsterdam, The Netherlands (R.P.K., J.E., R.J.W., J.J.W.).
authors.forename: Robin P
authors.initials: RP
authors.lastname: Kraak
authors.affiliation: Department of Pathology, Academic Medical Center - University of Amsterdam, The Netherlands (H.H.B., C.A.A., A.C.W.).
authors.forename: Hans H
authors.initials: HH
authors.lastname: de Boer
authors.affiliation: AMC Heartcenter, Academic Medical Center - University of Amsterdam, The Netherlands (R.P.K., J.E., R.J.W., J.J.W.).
authors.forename: Joëlle
authors.initials: J
authors.lastname: Elias
authors.affiliation: Department of Pathology, Academic Medical Center - University of Amsterdam, The Netherlands (H.H.B., C.A.A., A.C.W.).
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Ambarus
authors.affiliation: Department of Pathology, Academic Medical Center - University of Amsterdam, The Netherlands (H.H.B., C.A.A., A.C.W.).
authors.forename: Allard C
authors.initials: AC
authors.lastname: van der Wal
authors.affiliation: AMC Heartcenter, Academic Medical Center - University of Amsterdam, The Netherlands (R.P.K., J.E., R.J.W., J.J.W.).
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.affiliation: AMC Heartcenter, Academic Medical Center - University of Amsterdam, The Netherlands (R.P.K., J.E., R.J.W., J.J.W.).
authors.forename: Joanna J
authors.initials: JJ
authors.lastname: Wykrzykowska
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001344:Autopsy; D001706:Biopsy; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging / Q000187:drug effects* / Q000473:pathology; D000068338:Everolimus / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011474:Prosthesis Design; D013997:Time Factors; D016896:Treatment Outcome; D066253:Vascular Remodeling / Q000187:drug effects*; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D000068338:Everolimus
keywords: absorb; bioresorbable scaffold; pathology