CRT 2017 late-breaking trials

摘要

The ABSORB bioresorbable vascular scaffold (BVS) is a novel first-generation technology, which compared with contemporary metallic drug-eluting stents (DES) has thicker struts, different expansion characteristics, and loss of structural integrity during the active bioresorption process. Previous intra-vascular ultrasound (IVUS) studies have shown that the strongest predictors of thrombosis and restenosis with metallic DES are a small minimum stent area (MSA), untreated significant edge dissections, and untreated residual disease, and there is no reason to think that these parameters would be less important with BVS. Acute malapposition, which may increase the likelihood of intraluminal scaffold dismantling, may be even more important to prevent with BVS than with metallic DES. These concerns have led to the "PSP" concept, which stands for Prepare the lesion, Size the scaffold correctly, and Post dilate all stent with high pressure, non-compliant balloon to achieve maximum apposition. This technique has been recommended to lower the rate of stent thrombosis. To understand the impact of this technique on the rate of stent thrombosis that was seen in the ABSORB III trial, Gregg Stone, MD, from Columbia University Medical Center, presented the pooled multivariable analysis from the ongoing ABSROBIV trial.