title: Overlapping implantation of bioresorbable novolimus-eluting scaffolds: an observational optical coherence tomography study.
abstract: Overlapping implantation of bioresorbable vascular scaffolds is frequently necessary, but its influence on vessel and scaffold structure has not been thoroughly analyzed previously. The aim of this study was to analyze the acute effects of overlapping implantation on BRS as determined by optical coherence tomography (OCT). A total of 38 patients with de novo coronary artery stenoses who underwent OCT in the context of implantation of novolimus-eluting BRS (DESolve, Elixir Medical Corporation, Sunnyvale, California, USA) were investigated. In 15 patients, overlapping implantation of two BRS was performed, while 23 patients with implantation of one single BRS served as the control group. OCT data were retrospectively analyzed regarding acute scaffold implantation results. There were no significant differences between the overlap and control group in terms of residual in-scaffold area stenosis, scaffold area, mean or minimal lumen area, eccentricity index, incomplete scaffold apposition area or malapposition. While strut fracture was slightly more frequent in BRS with overlap its incidence was low overall. In patients with overlapping BRS, overlap segments did not display smaller lumen areas than segments without overlap (mean lumen area overlap: 8.16 ± 2.97 mm2vs. no overlap: 7.70 ± 2.55 mm2; p = 0.71; minimal lumen area overlap: 6.83 ± 2.71 mm2vs. no overlap: 6.17 ± 2.58 mm2; p = 0.37). Acute mechanical performance of novolimus-eluting BRS is not impaired by overlapping implantation. It can be assumed that vessel expansion compensates for the double scaffold layer in the overlap area resulting in a similar lumen area in overlap areas and in those with a single strut layer.
authors.affiliation: Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Department of Medicine 2-Cardiology, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany. florian.blachutzik@uk-erlangen.de.
authors.forename: Florian
authors.identifier: http://orcid.org/0000-0002-7695-3663
authors.initials: F
authors.lastname: Blachutzik
authors.affiliation: Justus Liebig Universität Giessen, University Hospital Giessen, Medical Clinic I, Giessen, Germany.
authors.forename: Niklas
authors.initials: N
authors.lastname: Boeder
authors.affiliation: German Heart Centre Munich, Munich, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Wiebe
authors.affiliation: Careggi Hospital, Florence, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Mattesini
authors.affiliation: Justus Liebig Universität Giessen, University Hospital Giessen, Medical Clinic I, Giessen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Dörr
authors.affiliation: Justus Liebig Universität Giessen, University Hospital Giessen, Medical Clinic I, Giessen, Germany.
authors.forename: Astrid
authors.initials: A
authors.lastname: Most
authors.affiliation: Justus Liebig Universität Giessen, University Hospital Giessen, Medical Clinic I, Giessen, Germany.
authors.forename: Timm
authors.initials: T
authors.lastname: Bauer
authors.affiliation: Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Department of Medicine 2-Cardiology, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.
authors.forename: Monique
authors.initials: M
authors.lastname: Tröbs
authors.affiliation: Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Department of Medicine 2-Cardiology, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Röther
authors.affiliation: Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Department of Medicine 2-Cardiology, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Schlundt
authors.affiliation: Friedrich-Alexander Universität Erlangen-Nürnberg (FAU), Department of Medicine 2-Cardiology, University Hospital Erlangen, Ulmenweg 18, 91054, Erlangen, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Achenbach
authors.affiliation: Justus Liebig Universität Giessen, University Hospital Giessen, Medical Clinic I, Giessen, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hamm
authors.affiliation: Justus Liebig Universität Giessen, University Hospital Giessen, Medical Clinic I, Giessen, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Nef
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000601:surgery*; D000068338:Everolimus / Q000494:pharmacology; D005260:Female; D005858:Germany; D006801:Humans; D018942:Macrolides / Q000494:pharmacology*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D012189:Retrospective Studies; D054457:Tissue Scaffolds; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
chemical_list: D018942:Macrolides; C534800:novolimus; D000068338:Everolimus
keywords: Bioresorbable Scaffold; Optical coherence tomography; Percutaneous coronary intervention