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Temporal changes of coronary artery plaque located behind the struts of the everolimus eluting bioresorbable vascular scaffold

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Abstract

Implantation of a coronary stent results in a mechanical enlargement of the coronary lumen with stretching of the surrounding atherosclerotic plaque. Using intravascular ultrasound virtual-histology (IVUS-VH) we examined the temporal changes in composition of the plaque behind the struts (PBS) following the implantation of the everolimus eluting bioresorbable vascular scaffold (BVS). Using IVUS-VH and dedicated software, the composition of plaque was analyzed in all patients from the ABSORB B trial who were imaged with a commercially available IVUS-VH console (s5i system, Volcano Corporation, Rancho Cordova, CA, USA) post-treatment and at 6-month follow-up. This dedicated software enabled analysis of the PBS after subtraction of the VH signal generated by the struts. The presence of necrotic core (NC) in contact with the lumen was also evaluated at baseline and follow-up. IVUS-VH data, recorded with s5i system, were available at baseline and 6-month follow-up in 15 patients and demonstrated an increase in both the area of PBS (2.45 ± 1.93 mm2 vs. 3.19 ± 2.48 mm2, P = 0.005) and the external elastic membrane area (13.76 ± 4.07 mm2 vs. 14.76 ± 4.56 mm2, P = 0.006). Compared to baseline there was a significant progression in the NC (0.85 ± 0.70 mm2 vs. 1.21 ± 0.92 mm2, P = 0.010) and fibrous tissue area (0.88 ± 0.79 mm2 vs. 1.15 ± 1.05 mm2, P = 0.027) of the PBS. The NC in contact with the lumen in the treated segment did not increase with follow-up (7.33 vs. 6.36%, P = 0.2). Serial IVUS-VH analysis of BVS-treated lesions at 6-month demonstrated a progression in the NC and fibrous tissue content of PBS.

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Authors and Affiliations

  1. Thoraxcenter, Erasmus MC, Ba-583, ‘s Gravendijkwal 230, 3015 CE, Rotterdam, The Netherlands

    Salvatore Brugaletta, Hector M. Garcia-Garcia, Scot Garg, Josep Gomez-Lara, Roberto Diletti, Yoshinobu Onuma, Robert Jan van Geuns & Patrick W. Serruys

  2. Cardialysis B.V, Rotterdam, The Netherlands

    Hector M. Garcia-Garcia

  3. Chrischurch Hospital, Chrischurch, New Zealand

    Dougal McClean

  4. Jagiellonian University, Krakow, Poland

    Dariusz Dudek

  5. Skejby Sygehus, Aarhus, Denmark

    Leif Thuesen

  6. Institut Cardiovasculaire Paris Sud, Massy, France

    Bernard Chevalier

  7. Bern University Hospital, Bern, Switzerland

    Stephan Windecker

  8. St Vincents Hospital, Fitzroy, Australia

    Robert Whitbourn

  9. Abbott Vascular, Diegem, Belgium

    Cecile Dorange, Karine Miquel-Hebert & Krishnankutty Sudhir

  10. Department of Cardiology, Auckland City Hospital, Auckland, New Zealand

    John A. Ormiston

Authors
  1. Salvatore Brugaletta
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  18. Patrick W. Serruys
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Correspondence to Patrick W. Serruys.

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Brugaletta, S., Garcia-Garcia, H.M., Garg, S. et al. Temporal changes of coronary artery plaque located behind the struts of the everolimus eluting bioresorbable vascular scaffold. Int J Cardiovasc Imaging 27, 859–866 (2011). https://doi.org/10.1007/s10554-010-9724-y

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