title: Bioresorbable Scaffold vs. Second Generation Drug Eluting Stent in Long Coronary Lesions requiring Overlap: A Propensity-Matched Comparison (the UNDERDOGS study).
abstract: BACKGROUND
  Randomized clinical trials on bioresorbable scaffolds (BRS) enrolled patients with simple coronary lesions. The present study was sought to give preliminary findings about safety of BRS implantation in overlap in long coronary lesions.
  
  
  METHODS
  From June 2012 to January 2015, we prospectively collected data from 162 consecutive patients receiving overlapping BRS implantation in the 16 participating institutions. We applied a propensity-score to match BRS-treated patients with 162 patients receiving second generation drug eluting stents (DES) in overlap. The primary endpoint was a device-oriented endpoint (DOCE), including cardiac death, target vessel myocardial infarction, and target lesion revascularization.
  
  
  RESULTS
  DOCE rate did not significantly differ between the two groups (5.6% in BRS group vs. 7.4% in DES group, HR 0.79, 95%CI 0.37-3.55, p=0.6). Also stent/scaffold thrombosis did not differ between groups (1.2% in BRS group vs. 1.9% in DES group, p=0.6). Occurrence of procedural-related myocardial injury was significantly higher in the BRS group (25% vs. 12%, p=0.001), although it was not related to DOCE (HR 1.1, 95%CI 0.97-1.2, p=0.2). Imaging techniques and enhanced stent visualization systems were significantly more employed in the BRS group (p=0.0001 for both). Procedure length, fluoroscopy time and contrast dye amount were significantly higher in the BRS group (p=0.001, p=0.001 and p=0.01, respectively).
  
  
  CONCLUSIONS
  Overlapping BRS utilization in long coronary lesions showed a comparable DOCE rate at 1year if compared to second generation DES. Further and larger studies are on demand to confirm our findings.
authors.affiliation: Cardiovascular Section, Medical Sciences Department, Azienda Ospedaliera Universitaria S.Anna, Ferrara, Italy. Electronic address: bscsmn@unife.it.
authors.forename: Simone
authors.initials: S
authors.lastname: Biscaglia
authors.affiliation: Interventional Cardiology, San Giovanni Bosco Hospital, Turin, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ugo
authors.affiliation: Cardiology Division, , Bolognini Hospital, Seriate, Italy.
authors.forename: Alfonso
authors.initials: A
authors.lastname: Ielasi
authors.affiliation: Interventional Cardiology, Santi Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy.
authors.forename: Gioel Gabrio
authors.initials: GG
authors.lastname: Secco
authors.affiliation: Cardiologia, Ospedale Valduce, Como, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Durante
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.affiliation: Division of Cardiology, Infermi Hospital, Rivoli, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Cerrato
authors.affiliation: King Saud Bin Abdulaziz University for Health Sciences, KACC, National Guard, Riyadh, ,Saudi Arabia.
authors.forename: Mohammed
authors.initials: M
authors.lastname: Balghith
authors.affiliation: Ospedali Riuniti Padova Sud, Monselice, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Pasquetto
authors.affiliation: Divisione di Cardiologia, Ospedale Civile, Mirano, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Penzo
authors.affiliation: U.O. Emodinamica, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Fineschi
authors.affiliation: UOS Emodinamica, Ospedale San Giuseppe, Azienda USL 11, Empoli, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Bonechi
authors.affiliation: Department of Cardiology, University Heart Center, University Hospital Zürich, Zürich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Templin
authors.affiliation: Department of Cardiovascular Disease, Infermi Hospital, Rimini, Italy.
authors.forename: Mila
authors.initials: M
authors.lastname: Menozzi
authors.affiliation: U.O. Cardiologia, Ospedale S. Maria delle Croci, Ravenna, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Aquilina
authors.affiliation: Cardiologia 2, A.O.U. Maggiore della Carità, Novara, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rognoni
authors.affiliation: Division of Cardiology, San Giovanni Bosco Hospital, Turin, Italy.
authors.forename: Piera
authors.initials: P
authors.lastname: Capasso
authors.affiliation: NIHR Cardiovascular Biomedical Research Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: Cardiology Department; Thorax Institute; IDIBAPS, University of Barcelona, Hospital Clinic, Barcelona, Spain.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.affiliation: LTTA Center, Ferrara, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Campo
mesh_terms: D020341:Absorbable Implants / Q000639:trends; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000639:trends; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome
keywords: Bioresorbable scaffold; Drug eluting stent; Long lesions; Overlap