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Promising results observed for bioresorbable vascular scaffold in STEMI
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Encouraging event-free survival outcomes were reported for bioresorbable vascular scaffold implantation in a cohort of patients who underwent primary PCI for acute STEMI, according to findings published in the European Heart Journal.
The prospective, multicenter Prague 19 study was conducted to investigate the feasibility and safety of a bioresorbable vascular scaffold (Absorb version 1.1, Abbott Vascular) in acute STEMI. Clinicians used the scaffold approach as the default strategy for 142 consecutive patients with STEMI between Dec. 15, 2012 and Aug. 30, 2013. Of this group, 28.9% (n=41) met eligibility criteria for bioresorbable vascular scaffold implantation after undergoing primary PCI.
The investigators reported a 98% success rate for the bioresorbable vascular scaffold device. Ninety-five percent of the patients experienced restored TIMI 3 flow. The rate of acute scaffold recoil was 9.7%.
The analysis also included an optical coherence tomography substudy, the results of which indicated a 1.1% rate of scaffold strut malapposition.
Small and clinically silent edge dissections were observed in 38% of the patient population.
Assessing reference vessel diameter by quantitative coronary angiography yielded significantly lower measurements than those assessed by OCT (–0.29 ± 0.56 mm; P=.028).
Study protocols called for a comparison of a composite clinical outcome of death, MI or target vessel revascularization between the bioresorbable scaffold group and the control group defined as patients with metallic stents and Killip Class I or II. Results indicated no significant difference in event-free survival between the groups (scaffold group, 95% vs. controls, 93%; P=.674).
“Bioresorbable vascular scaffold implantation in acute STEMI is feasible and safe,” the investigators concluded, adding that they were encouraged by the procedural results evaluated by angiography and OCT.
Disclosure: Two of the investigators report financial disclosures with Abbott Vascular.
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