title: Impact of Implantation Technique and Plaque Morphology on Strut Embedment and Scaffold Expansion of Polylactide Bioresorbable Scaffold　- Insights From ABSORB Japan Trial.
abstract: The optimal implantation technique for the bioresorbable scaffold (Absorb, Abbott Vascular) is still a matter of debate. The purpose of the present study was to evaluate the effect of implantation technique on strut embedment and scaffold expansion.
  
  
  
  Strut embedment depth and scaffold expansion index assessed by optical coherence tomography (OCT) (minimum scaffold area/reference vessel area) were evaluated in the ABSORB Japan trial (OCT subgroup: 87 lesions) with respect to implantation technique using either quantitative coronary angiography (QCA) or OCT. Strut embedment was assessed at the strut level (n=667), while scaffold expansion was assessed at the lesion level (n=81). The mean embedment depth was 63±59 µm. Balloon sizing and inflation pressure had no direct effect on strut embedment. Plaque morphology affected strut embedment [nonatherosclerotic (58.9±54.3 µm), fibroatheroma (73.3±59.6 µm), fibrous plaque (59.7±51.1 µm), and fibrocalcific plaque (-3.1±61.6 µm, negative value means malapposition), P <0.001]. The balloon-artery ratio positively correlated with the expansion index. This relationship was stronger when the OCT-derived reference vessel diameter (RVD) was used as a reference for balloon selection rather than the QCA-derived one [predilatation (Pearson correlation r: QCA: 0.167 vs. OCT: 0.552), postdilatation (QCA: 0.316 vs. OCT: 0.717)].
  
  
  
  Underlying plaque morphology influenced strut embedment, whereas implantation technique had no direct effect on it. Optimal balloon sizing based on OCT-derived RVD might be recommended. However, the safety of such a strategy should be investigated in a prospective trial. (Circ J 2016; 80: 2317-2326).
authors.affiliation: Academic Medical Center, University of Amsterdam.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Sotomi
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.forename: Jouke
authors.initials: J
authors.lastname: Dijkstra
authors.forename: Jeroen
authors.initials: J
authors.lastname: Eggermont
authors.forename: Shengnan
authors.initials: S
authors.lastname: Liu
authors.forename: Erhan
authors.initials: E
authors.lastname: Tenekecioglu
authors.forename: Yaping
authors.initials: Y
authors.lastname: Zeng
authors.forename: Taku
authors.initials: T
authors.lastname: Asano
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Popma
authors.forename: Ken
authors.initials: K
authors.lastname: Kozuma
authors.forename: Kengo
authors.initials: K
authors.lastname: Tanabe
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D020341:Absorbable Implants; D001807:Blood Vessel Prosthesis; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods*; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D008297:Male; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000601:surgery; D011091:Polyesters; D054457:Tissue Scaffolds
chemical_list: D011091:Polyesters; C033616:poly(lactide)