title: Bioresorbable Everolimus-Eluting Vascular Scaffold for Long Coronary Lesions: A Subanalysis of the International, Multicenter GHOST-EU Registry.
abstract: The authors sought to investigate 1-year outcomes in patients treated with bioresorbable everolimus-eluting vascular scaffolds (BVS) for "long coronary lesions."
  
  
  
  The present substudy derived from the GHOST-EU registry included 1,722 lesions in 1,468 consecutive patients, enrolled between November 2011 and September 2014 at 11 European centers.
  
  
  
  The lesions were divided into 3 groups according to continuous BVS length: 1) shorter than 30 mm; 2) between 30 and 60 mm; and 3) longer than 60 mm. Primary device-oriented endpoint (target lesion failure [TLF]) was defined as a combination of cardiovascular death, target vessel myocardial infarction, or clinically driven target lesion revascularization.
  
  
  
  Patients with lesions ≥60 mm had more comorbidities and more complex lesion characteristics, including chronic total occlusions (37%), bifurcation lesions (40.3%), higher Syntax score (16.4 ± 7.8), and higher number of scaffolds implanted per lesion (3.3 ± 0.9 mm). The main target vessel was the left anterior coronary artery in all groups. Median follow-up was 384 (interquartile range: 359 to 459) days. One-year follow-up was completed in 70.3% of patients. TLF at 1 year was significantly higher in group C (group A 4.8%, group B 4.5%, group C 14.3%; overall p = 0.001), whereas there were no significant differences between groups A and B. Finally, a numerically higher (but not statistically significant) number of scaffold thromboses were observed in group C when compared with shorter lesions (group A 2.1%, group B 1.1%, group C 3.8%; overall p = 0.29).
  
  
  
  In a real-world setting, treatment of long coronary lesions with BVS ≥60 mm was associated with a higher TLF rate, driven by myocardial infarction and clinically driven target lesion revascularization.
authors.affiliation: San Giovanni di Dio Hospital, Agrigento, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Geraci
authors.affiliation: EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawamoto
authors.affiliation: San Giovanni di Dio Hospital, Agrigento, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Caramanno
authors.affiliation: EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.
authors.forename: Neil
authors.initials: N
authors.lastname: Ruparelia
authors.affiliation: Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Capodanno
authors.affiliation: Department of Cardiology, Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Brugaletta
authors.affiliation: Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz, Germany.
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gori
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Nef
authors.affiliation: Department of Cardiology, Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain.
authors.forename: Manel
authors.initials: M
authors.lastname: Sabate
authors.affiliation: Department of Cardiology, Klinikum Großhadern, Ludwig-Maximilian Universität, Munich, Germany.
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.affiliation: Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Lesiak
authors.affiliation: Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Naber
authors.affiliation: National Institute of Health Research Cardiovascular BRU, Royal Brompton Hospital & Imperial College, London, United Kingdom.
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Mario
authors.affiliation: Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Piera
authors.initials: P
authors.lastname: Capranzano
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany.
authors.forename: Jens
authors.initials: J
authors.lastname: Wiebe
authors.affiliation: Department of Cardiology, University of Medical Sciences, Poznan, Poland.
authors.forename: Aleksander
authors.initials: A
authors.lastname: Araszkiewicz
authors.affiliation: Klinik für Kardiologie und Angiologie, Elisabeth-Krankenhaus, Essen, Germany.
authors.forename: Stelios
authors.initials: S
authors.lastname: Pyxaras
authors.affiliation: National Institute of Health Research Cardiovascular BRU, Royal Brompton Hospital & Imperial College, London, United Kingdom.
authors.forename: Alessio
authors.initials: A
authors.lastname: Mattesini
authors.affiliation: Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz, University Medical Center, Mainz, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.affiliation: Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.affiliation: EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.affiliation: EMO-GVM Centro Cuore and San Raffaele Hospitals, Milan, Italy. Electronic address: info@emocolumbus.it.
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage* / Q000009:adverse effects; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D003328:Coronary Thrombosis / Q000209:etiology; D005060:Europe; D000068338:Everolimus / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016016:Proportional Hazards Models; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D020099:Coated Materials, Biocompatible; D000068338:Everolimus
keywords: bioresorbable vascular scaffolds; complex coronary lesions; long coronary lesions; vascular reparative therapy