title: Everolimus-eluting bioresorbable vascular scaffolds implanted in coronary bifurcation lesions: Impact of polymeric wide struts on side-branch impairment.
abstract: BACKGROUND
  Limited data are available on bioresorbable vascular scaffolds (BVS) performance in bifurcations lesions and on the impact of BVS wider struts on side-branch impairment.
  
  
  METHODS
  Patients with at least one coronary bifurcation lesion involving a side-branch ≥2mm in diameter and treated with at least one BVS were examined. Procedural and angiographic data were collected and a dedicated methodology for off-line quantitative coronary angiography (QCA) in bifurcation was applied (eleven-segment model), to assess side-branch impairment occurring any time during the procedure. Two- and three-dimensional QCA were used. Optical coherence tomography (OCT) analysis was performed in a subgroup of patients and long-term clinical outcomes reported.
  
  
  RESULTS
  A total of 102 patients with 107 lesions, were evaluated. Device- and procedural-successes were 99.1% and 94.3%, respectively. Side-branch impairment occurring any time during the procedure was reported in 13 bifurcations (12.1%) and at the end of the procedure in 6.5%. Side-branch minimal lumen diameter (Pre: 1.45±0.41mm vs Final: 1.48±0.42mm, p=0.587) %diameter-stenosis (Pre: 26.93±16.89% vs Final: 27.80±15.57%, p=0.904) and minimal lumen area (Pre: 1.97±0.89mm(2) vs Final: 2.17±1.09mm(2), p=0.334), were not significantly affected by BVS implantation. Mean malapposed struts at the bifurcation polygon-of-confluence were 0.63±1.11.
  
  
  CONCLUSIONS
  The results of the present investigation suggest feasibility and relative safety of BVS implantation in coronary bifurcations. BVS wide struts have a low impact on side-branch impairment when considering bifurcations with side-branch diameter≥2mm.
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Marcella
authors.initials: M
authors.lastname: De Paolis
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Cordula
authors.initials: C
authors.lastname: Felix
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Nienke
authors.initials: N
authors.lastname: van Ditzhuijzen
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Jiang Ming
authors.initials: JM
authors.lastname: Fam
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Antonis
authors.initials: A
authors.lastname: Karanasos
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Sanneke
authors.initials: S
authors.lastname: de Boer
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Nicolas M
authors.initials: NM
authors.lastname: van Mieghem
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: Daemen
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Francesco
authors.initials: F
authors.lastname: Costa
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Luis Carlos
authors.initials: LC
authors.lastname: Bergoli
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Jurgen M R
authors.initials: JM
authors.lastname: Ligthart
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Peter P
authors.initials: PP
authors.lastname: de Jaegere
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: Robert Jan
authors.initials: RJ
authors.lastname: van Geuns
authors.affiliation: Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. Electronic address: r.diletti@erasmusmc.nl.
authors.forename: Roberto
authors.initials: R
authors.lastname: Diletti
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D054855:Drug-Eluting Stents; D000068338:Everolimus / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011108:Polymers; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D054457:Tissue Scaffolds; D041623:Tomography, Optical Coherence / Q000379:methods
chemical_list: D011108:Polymers; D000068338:Everolimus
keywords: Bifurcations; Bioresorbable vascular scaffold; Optical coherence tomography; Quantitative coronary angiography; Side-branch