Bioresorbable Magnesium-Based Stent: Real-World Clinical Experience and Feasibility of Follow-Up by Coronary Computed Tomography: A New Window to Look at New Scaffolds

Figures

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  Figure 1. Kaplan–Meier survival curves between the elective and acute coronary syndrome (ACS) groups. MI = Myocardial Infarction; TVR = Target Vessel Revascularization; TLR = Target Lesion Revascularization.

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  Figure 2. In-stent restenosis post-implantation of one DREAMS-2G stent in a right coronary artery lesion. MLD by QCA post-stent implantation was found to be 3.13 mm; reference 3.93 mm (Panel (A)). In-stent restenosis was found 8 months post-implantation with MLD by QCA of 1.2 mm (Panel (B)). Pathological functional assessment by FFR (0.77) was found upon revascularization (Panel (C)). IVUS pullback showed in-stent restenosis and an MLA of 3.03 mm2 secondary to a collapse of stent struts more than intrastent neointimal proliferation, the plaque burden was 83% (Panel (D)). FFR = Fractional Flow Reserve; IVUS = Intravascular Ultrasound; MLA = Minimal Lumen Area; MLD = Minimal Lumen Diameter; QCA = Quantitative Coronary Angiography.

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  Figure 3. In-stent restenosis of a DREAMS-2G stent implanted in a proximal left anterior descending artery. In-stent restenosis by Coronary Computed Tomography Angiography 6-months post-stent implantation was suspected with a minimal in-stent lumen area (MLA) of 2.3 mm2. Panel (A) shows one slice of the CT without contrast, on which the proximal tantarum of the stent is visible (white arrow), the lumen of the artery (yellow arrow) is free from any metallic stent struts with blooming effect, while some parietal calcifications are visible (*). In-stent restenosis was confirmed by a coronary angiogram 8 months post-implantation with a minimal lumen diameter of 1.41 mm by quantitative coronary angiography (Panel (B)) and a pathological fractional flow reserve (0.77) (Panel (C)). An intravascular ultrasound (IVUS) pullback demonstrated in-stent restenosis with an MLA of 2.64 mm2 (Panel (D)).

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  Figure 4. Cross sectional cut of a proximal left anterior descending artery and in-stent minimal lumen area. The two radiopaque spots (stars) are the tantarum markers at the proximal and distal edges of the stent with no discernible struts. Points A and B refer to cross sections at the respective levels.

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  Figure 5. Quantitative Coronary Angiography (QCA) and Coronary Computed Tomography Angiography (CCTA) correlation and agreement. Passing-Bablok regression analyses on the left and Bland-Altman analyses on the right.