title: Bioresorbable vascular scaffolds in STEMI patients: multimodality imaging comparison in mid-term perspective.
abstract: BACKGROUND
  Bioresorbable vascular scaffolds (BVS) represent an exciting and novel coronary intervention technology. BVS implantation could play an important role in the acute ST elevation myocardial infarction (STEMI) setting, with mid- and long-term follow-up data still scarce.
  
  
  METHODS
  PRAGUE-19 is a prospective double-center single arm study that tests the performance and safety of BVS implantation during primary percutaneous coronary intervention (pPCI) in the STEMI setting. During the enrollment period 70 patients were included, quantitative coronary angiography (QCA) was done immediately after BVS implantation and optical coherence tomography (OCT) study was suggested but not mandatory; subsequently serial clinical follow-up was scheduled and research computed tomography (CT) angiography at 1 year was performed. The current study focused on a group of 22 patients who had complete multi-imaging data (QCA and OCT immediately post-procedure and CT at 1 year after implantation) and aimed to analyze the quantitative measurements of these different techniques.
  
  
  RESULTS
  All 25 BVS implanted in 22 patients were widely patent at 1-year CT angiography. Immediately after pPCI, QCA measurements of vessel size were smaller than OCT with statistical significance: mean reference vessel diameter (RVD) was respectively 3.1±0.4 versus 3.4±0.5 mm (P<0.001), mean minimum lumen diameter (MLD) 2.5±0.3 versus 3.0±0.3 mm (P<0.001) and mean BVS diameter 2.8±0.3 versus 3.26±0.29 mm (P=0.001). Mean RVD and reference vessel area (RVA) were larger at 1 year CT angiography in comparison to baseline OCT (3.4±0.5 mm versus 3.76±0.45 mm, P=0.009, and 9.27±2.7 mm2 versus 11.28±2.62 mm2, P=0.01, respectively) and MLD was also larger at follow-up: 2.96±0.29 mm versus 3.09±0.53 (P=0.077). However, the mean percent area stenosis (parameter not influenced by possible difference between different methods) measured with OCT immediately after pPCI and with CT angiography at 1 year did not show any difference (20.2±23.9% versus 24.8±17.8%, P=0.478).
  
  
  CONCLUSIONS
  In comparison with OCT, QCA largely underestimates luminal diameters and may interfere with BVS proper sizing. CT angiography did not identify any evidence of binary restenosis, confirming the effective anti-restenotic properties of BVS at mid-term follow-up.
authors.affiliation: Department of Cardiology, University Hospital of Verona, Verona, Italy - viktor.kocka@fnkv.cz.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Marchese
authors.forename: Robert
authors.initials: R
authors.lastname: Petr
authors.forename: Petr
authors.initials: P
authors.lastname: Tousek
authors.forename: Petr
authors.initials: P
authors.lastname: Widimsky
authors.forename: Viktor
authors.initials: V
authors.lastname: Kocka
mesh_terms: D000368:Aged; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods* / Q000401:mortality; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods*; D062645:Percutaneous Coronary Intervention / Q000379:methods; D011446:Prospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014057:Tomography, X-Ray Computed