title: Outcome After Long-segment Stenting With Everolimus-eluting Bioresorbable Scaffolds Focusing on the Concept of Overlapping Implantation.
abstract: OBJECTIVE
  The implantation of bioresorbable scaffolds (BRS) is an emerging technique used in percutaneous coronary interventions. Their application has been extended to more complex lesions, although evidence is only available for simple lesions. The present study evaluated scaffold implantation in long lesions, focusing on overlapping scaffolds.
  
  
  METHODS
  We retrospectively analyzed all consecutive patients eligible for stenting with everolimus-eluting poly-L-lactic acid-based BRS with a minimum total scaffold length of 28mm, irrespective of the number of BRS used. The main target parameters were major adverse cardiac events, comprising cardiac death, any myocardial infarction, and target lesion revascularization, and target lesion failure, including cardiac death, target vessel myocardial infarction, and target lesion revascularization. A subgroup analysis included patients with overlapping BRS.
  
  
  RESULTS
  A total of 250 patients were included. The reason for angiography was stable coronary artery disease in 36.4% (91 of 250), an acute coronary syndrome in 61.6% (154 of 250), and other reasons in 2.0% (5 of 250). Procedural success was achieved in 97.8% (267 of 273) of the lesions. During follow-up, the 12-month rates of major adverse cardiac event, target lesion failure, and scaffold thrombosis were 8.5%, 6.6%, and 2.3%, respectively. Subgroup analysis of 239 patients showed that there were no statistically relevant differences between patients with and without overlapping scaffolds after a 12-month follow-up.
  
  
  CONCLUSIONS
  Long-segment stenting with a single scaffold or with multiple overlapping scaffolds is technically feasible with adequate mid-term outcomes. However, large-scale randomized studies are needed to provide further proof of concept.
authors.affiliation: Department of Cardiology, University of Giessen, Medizinische Klinik I, Giessen, Germany; Deutsches Herzzentrum München, Munich, Germany. Electronic address: jens.wiebe@googlemail.com.
authors.forename: Jens
authors.initials: J
authors.lastname: Wiebe
authors.affiliation: Department of Cardiology, University of Giessen, Medizinische Klinik I, Giessen, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Dörr
authors.affiliation: Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Liebetrau
authors.affiliation: Department of Cardiology, University of Giessen, Medizinische Klinik I, Giessen, Germany.
authors.forename: Timm
authors.initials: T
authors.lastname: Bauer
authors.affiliation: Department of Cardiology, University of Giessen, Medizinische Klinik I, Giessen, Germany.
authors.forename: Eva
authors.initials: E
authors.lastname: Wilkens
authors.affiliation: Department of Cardiology, University of Giessen, Medizinische Klinik I, Giessen, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Ilstad
authors.affiliation: Department of Cardiology, University of Giessen, Medizinische Klinik I, Giessen, Germany.
authors.forename: Niklas
authors.initials: N
authors.lastname: Boeder
authors.affiliation: Department of Cardiology, Heart Center Oldenburg, Oldenburg, Germany.
authors.forename: Albrecht
authors.initials: A
authors.lastname: Elsässer
authors.affiliation: Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Helge
authors.initials: H
authors.lastname: Möllmann
authors.affiliation: Department of Cardiology, University of Giessen, Medizinische Klinik I, Giessen, Germany; Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Christian W
authors.initials: CW
authors.lastname: Hamm
authors.affiliation: Department of Cardiology, University of Giessen, Medizinische Klinik I, Giessen, Germany.
authors.forename: Holger M
authors.initials: HM
authors.lastname: Nef
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D054855:Drug-Eluting Stents; D004562:Electrocardiography; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D011474:Prosthesis Design; D012189:Retrospective Studies; D013997:Time Factors; D054457:Tissue Scaffolds
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus
keywords: Angioplastia coronaria; Cateterismo; Catheterization; Coronary angioplasty; Coronary disease; Enfermedad coronaria; Stent