title: Bioresorbable vascular scaffold use for coronary bifurcation lesions: A substudy from GHOST EU registry.
abstract: OBJECTIVE
  The aim of this study was to evaluate midterm outcomes of bioresorbable vascular scaffolds (BVS) implanted in bifurcation lesions.
  
  
  BACKGROUND
  BVS have emerged as an alternative to conventional metallic drug-eluting stents for the treatment of coronary complex lesions.
  
  
  METHODS
  Between November 2011 and January 2014, 1189 patients underwent percutaneous coronary intervention with BVS at 10 European centers (GHOST EU registry). Of these, 289 consecutive patients (302 bifurcation lesions) treated with either single-stenting (n = 260) or double-stenting (n = 42) were evaluated.
  
  
  RESULTS
  True bifurcations were treated in 44.7%. Intravascular ultrasound and optical coherence tomography were utilized only in 22.2% and 21.2%, respectively. Predilation was performed in 95.4%, while postdilation of the main branch was performed in 61.3%. Final kissing inflation with no or minimal protrusion of a side-branch balloon into main branch was performed in 18.9%. Median follow-up period was 356 (IQR 191-419) days. The Kaplan-Meier estimated rates of target lesion failure and scaffold thrombosis (ST) were 6.4% and 2.5% at 360 days, respectively. Independent predictors for TLF were ACS and diabetes mellitus (HR 4.67; 95% CI: 1.78-12.3; P = 0.002 and HR 3.37; 95% CI: 1.38-8.26; P = 0.008, respectively).
  
  
  CONCLUSIONS
  BVS use for coronary bifurcation lesions in an "all-comer" population was associated with acceptable TLF rates up to midterm follow-up. However, ST rates were higher than seen with contemporary metallic stents possibly due to the low incidence of intravascular guidance and postdilation resulting in a higher likelihood of scaffold underexpansion and malapposition, further supporting the importance of meticulous implantation technique. © 2016 Wiley Periodicals, Inc.
authors.affiliation: EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.|New Tokyo Hospital, Chiba, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Naganuma
authors.affiliation: EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.affiliation: Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Lesiak
authors.affiliation: Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Capodanno
authors.affiliation: Medizinische Klinik Und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz, Germany.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gori
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Nef
authors.affiliation: San Giovanni Di Dio Hospital, Agrigento, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caramanno
authors.affiliation: Klinik Für Kardiologie Und Angiologie, Elisabeth-Krankenhaus, Essen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Naber
authors.affiliation: National Institute of Health Research Cardiovascular BRU, Royal Brompton Hospital and Imperial College, London, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.
authors.forename: Neil
authors.initials: N
authors.lastname: Ruparelia
authors.affiliation: Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Piera
authors.initials: P
authors.lastname: Capranzano
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Wiebe
authors.affiliation: Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Araszkiewicz
authors.affiliation: San Giovanni Di Dio Hospital, Agrigento, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Geraci
authors.affiliation: EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.|New Tokyo Hospital, Chiba, Japan.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawamoto
authors.affiliation: Klinik Für Kardiologie Und Angiologie, Elisabeth-Krankenhaus, Essen, Germany.
authors.forename: Stelios
authors.initials: S
authors.lastname: Pyxaras
authors.affiliation: National Institute of Health Research Cardiovascular BRU, Royal Brompton Hospital and Imperial College, London, United Kingdom.
authors.forename: Alessio
authors.initials: A
authors.lastname: Mattesini
authors.affiliation: Medizinische Klinik Und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.affiliation: Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.affiliation: EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
mesh_terms: D020341:Absorbable Implants; D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000628:therapy*; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology; D005060:Europe; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: bioresorbable vascular scaffold; coronary bifurcation; scaffold thrombosis