title: Implantation of bioresorbable vascular scaffolds following acute coronary syndrome is associated with reduced early neointimal growth and strut coverage.
abstract: OBJECTIVE
  Registry data have suggested higher than anticipated rates of scaffold thrombosis following bioresorbable vascular scaffold (BVS) implantation. We examined early neointimal growth and strut coverage in BVS to ascertain whether this was affected by clinical presentation.
  
  
  RESULTS
  Patients undergoing optical coherence tomography (OCT)-guided BVS implantation, either for stable angina (SA) or acute coronary syndrome (ACS), were recruited to this observational study. Repeat OCT was performed at follow-up (median 74 days), and scaffolds analysed at 1 mm longitudinal intervals for scaffold/flow area, scaffold apposition, neointimal growth and strut coverage. Twenty-nine BVS were included in the analysis (62% implanted following ACS). There were no differences in baseline patient/lesion characteristics. All BVS achieved >90% predicted scaffold area with only 1.64% of struts classified as incompletely apposed, compared with 0.47% at follow-up (p=0.006). Reductions in mean scaffold (-4.0%, p=0.01) and flow (-8.4%, p<0.001) areas were observed at follow-up, with larger reductions in mean flow area in stable patients (-14.5±14.2 vs. -4.9±7.9%, p=0.03). ACS patients had reduced neointimal growth (0.51±0.18 vs. 0.87±0.37 mm2, p=0.002), and increased percentage of uncovered struts (2.68±1.67 vs. 1.43±0.87%, p=0.015).
  
  
  CONCLUSIONS
  Early neointimal growth and strut coverage are reduced following ACS in patients receiving BVS. These results may, in part, explain the high rates of ST in registry data.
authors.affiliation: Department of Interventional Cardiology, Papworth Hospital, Cambridge, United Kingdom.
authors.forename: Joel P
authors.initials: JP
authors.lastname: Giblett
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Brown
authors.forename: Harry
authors.initials: H
authors.lastname: Keevil
authors.forename: Catherine
authors.initials: C
authors.lastname: Jaworski
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Hoole
authors.forename: Nick E J
authors.initials: NE
authors.lastname: West
mesh_terms: D020341:Absorbable Implants; D054058:Acute Coronary Syndrome / Q000601:surgery*; D000368:Aged; D060050:Angina, Stable / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation; D003331:Coronary Vessels / Q000637:transplantation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000000981:diagnostic imaging*; D054457:Tissue Scaffolds; D041623:Tomography, Optical Coherence