Bioresorbable vascular scaffolds in saphenous vein grafts (data from OCTOPUS registry)

Introduction

Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) with metallic stents is associated with a high rate of restenosis (19–21%) and target vessel failure in the long-term follow-up [1]. Potentially, implantation of a bioresorbable vascular scaffold (BVS) (ABSORB, Abbott Laboratories) into the stenotic SVG may be an alternative to metallic stents [2]. Although the effectiveness of BVS in treatment of de novo coronary lesions in native vessels is well documented [3], none of the previous studies evaluated the results of BVS implantation into SVG.
Recently, we reported an imaging follow-up of a case of successful BVS implantation to treat a de novo stenotic SVG lesion [4–6]. Therefore, in this report we present pilot results from the OCTOPUS registry of a subgroup of patients with significant de novo SVG stenosis treated with BVS implantation.

Methods

OCTOPUS is a single-center registry evaluating the morphology of SVG lesions and stent healing by multimodality imaging including optical coherence imaging (OCT) and assessing long-term clinical outcomes of SVG interventions in patients with stable coronary artery disease (CAD) and acute coronary syndromes (ACS). Here we focus on patients treated with BVS implantation into SVG. The study was approved by the Ethics Committee of the Medical University of Silesia and conforms to the Declaration of Helsinki. All of the patients were enrolled in the study only after the patient gave their informed written consent.

Inclusion criteria

The registry included patients with a history of coronary artery bypass grafting utilizing SVG with recurrent stable CAD or ACS. The study exclusion criteria were as follows: age < 18 years old, glomerular filtration rate less then 45 ml/min/1.72 m², severe valve disease warranting redo cardiac surgery and contrast allergy.

Quantitative coronary angiography

Quantitative angiography (QA) of SVG lesions was performed before and after BVS implantation using Horizon Cardiology 12.2 software (McKesson company) to evaluate reference lumen diameter (RLD), minimal lumen diameter (MLD), percentage diameter stenosis (%DS), and lesion length. At follow-up, MLD, %DS and late lumen loss (LLL) were evaluated. Late lumen loss was defined as the difference between the MLD immediately after the procedure and MLD at follow-up within the implanted BVS.

Optical coherence tomography imaging

Optical...


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