title: Comparison of acute expansion of bioresorbable vascular scaffolds versus metallic drug-eluting stents in different degrees of calcification: An Optical Coherence Tomography Study.
abstract: OBJECTIVE
  The acute expansion of bioresorbable vascular scaffolds (BRS) and drug-eluting stents (DES) in lesions with different extent of calcification was compared by Optical Coherence Tomography (OCT).
  
  
  BACKGROUND
  The acute mechanical performance of polymeric BRS in calcified lesions is poorly understood.
  
  
  METHODS
  Acute device performance in lesions treated with either BRS(N = 50) or DES (N = 50) was compared using Optical Coherence Tomography (OCT). According to angiographic degree of calcification the lesions were divided in three groups: no/mild, moderate and heavy calcification. Device performance was assessed with the following parameters by OCT: mean scaffold area, eccentricity index (EI), symmetry index (SI) and percentage incomplete strut apposition (ISA).
  
  
  RESULTS
  One hundred lesions from 85 patients (BRS/DES; 37/48) were analyzed. Scaffold area and SI were similar between BRS and DES groups in the three calcification subgroups. Compared to DES, EI in BRS was marginally lower in the no/mild calcification group (0.86 ± 0.03 versus 0.88 ± 0.03, p = 0.018) but was similar in the moderate and heavy calcification groups. Compared to DES, percentage ISA struts in BRS was similar in the no/mild calcification group and was significantly lower in the moderate and heavy calcification groups (2.96 ± 2.36 versus 6.78 ± 4.61%, p = 0.002 and 1.82 ± 2.40 versus 8.89 ± 8.25%, p = 0.025 respectively).
  
  
  CONCLUSIONS
  With adequate lesion preparation, implantation of BRS in a population reflective of clinical practice, resulted in a similar luminal gain compared to DES as measured by OCT, regardless of the degree of angiographic calcification, while acute malapposition is lower with BRS in moderately and heavily calcified lesions. The clinical significance of our findings warrants further evaluation in future studies. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.|National Heart Centre Singapore.
authors.forename: Jiang
authors.initials: J
authors.lastname: Ming Fam
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Johannes N
authors.initials: JN
authors.lastname: van Der Sijde
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Antonios
authors.initials: A
authors.lastname: Karanasos
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Cordula
authors.initials: C
authors.lastname: Felix
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Roberto
authors.initials: R
authors.lastname: Diletti
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Nicolas
authors.initials: N
authors.lastname: van Mieghem
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Peter
authors.initials: P
authors.lastname: de Jaegere
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Robert
authors.initials: R
authors.lastname: Jan van Geuns
authors.affiliation: Thorax Centre, Erasmus University Medical Centre, Rotterdam, Netherlands.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Regar
mesh_terms: D020341:Absorbable Implants; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011474:Prosthesis Design; D013997:Time Factors; D054457:Tissue Scaffolds; D041623:Tomography, Optical Coherence / Q000379:methods*; D016896:Treatment Outcome; D061205:Vascular Calcification / Q000175:diagnosis* / Q000601:surgery
keywords: angiographic calcification; bioresorbable vascular scaffolds; drug-eluting stents; optical coherence tomography; percutaneous coronary intervention