Post-dilatation after implantation of bioresorbable everolimus- and novolimus-eluting scaffolds: an observational optical coherence tomography study of acute mechanical effects

Blachutzik F, Boeder N, Wiebe J, Mattesini A, Doerr O, Most A, Bauer T, Röther J, Tröbs M, Schlundt C, Achenbach S, Hamm CW, Nef HM (2017)

Publication Type: Journal article

Publication year: 2017

Journal

Book Volume: 106

Pages Range: 271-279

Journal Issue: 4

DOI: 10.1007/s00392-016-1048-z

Abstract

OBJECTIVES: The objective was to investigate the acute mechanical effects of post-dilatation on bioresorbable scaffolds (BRS) as determined by optical coherence tomography (OCT). BACKGROUND: Post-dilatation with high-pressure balloons is regarded as a key component of BRS implantation for treatment of coronary artery stenoses. However, the impact of post-dilatation on BRS in vivo has not been thoroughly investigated. METHODS: OCT was performed after the implantation procedure of 51 everolimus-eluting or novolimus-eluting polylactic acid-based BRS with (n = 27) or without non-compliant balloon post-dilatation (n = 24). The number of malapposed struts, strut fractures, edge dissections, residual in-scaffold area stenosis, and incomplete scaffold apposition area was analyzed over the complete length of each BRS with a spacing of 1 mm. RESULTS: OCT revealed a significantly lower incomplete scaffold apposition area if post-dilatation was performed (0.16 ± 0.49 mm2with post-dilatation vs. 2.65 ± 2.78 mm2without post-dilatation, p < 0.001), as well as a significantly lower absolute number of malapposed struts (1 ± 2 with post-dilatation vs. 13 ± 13 without post-dilatation, p < 0.001). No significant differences regarding residual in-scaffold area stenosis, strut fracture, edge dissection, symmetry index, or eccentricity index were observed in patients with vs. without post-dilatation. CONCLUSION: Post-dilatation of BRS with non-compliant balloons significantly reduces the number of malapposed struts and incomplete scaffold apposition area without inducing higher rates of edge dissection or strut fracture.

Authors with CRIS profile

Involved external institutions

Justus-Liebig-Universität Gießen Germany (DE) Technische Universität München (TUM) Germany (DE) Careggi University Hospital / Azienda Ospedaliero Universitaria Careggi Italy (IT)

How to cite

APA:

Blachutzik, F., Boeder, N., Wiebe, J., Mattesini, A., Doerr, O., Most, A.,... Nef, H.M. (2017). Post-dilatation after implantation of bioresorbable everolimus- and novolimus-eluting scaffolds: an observational optical coherence tomography study of acute mechanical effects. Clinical Research in Cardiology, 106(4), 271-279. https://doi.org/10.1007/s00392-016-1048-z

MLA:

Blachutzik, Florian, et al. "Post-dilatation after implantation of bioresorbable everolimus- and novolimus-eluting scaffolds: an observational optical coherence tomography study of acute mechanical effects." Clinical Research in Cardiology 106.4 (2017): 271-279.

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