Impact of PSP Technique on Clinical Outcomes Following Bioresorbable Scaffolds Implantation

Figures

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  Figure 1. Scaffold thrombosis and PSP technique. The frequency of scaffold thrombosis according to the meta-analysis of Collet et al. [27] Imaging findings and mechanism according to Tanaka et al. [9], Sotomi et al. [28] and Yamaji et al. [29] Mechanism of failure as defined in Table 2. In the PSP technique issues, the primary failure mechanism is underlined followed with the suboptimal technique related. DAPT: Dual-antiplatelet therapy; HBR: High-bleeding risk.

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  Figure 2. Impact of PSP technique on device-oriented composite endpoint following bioresorbable scaffolds implantation. HR and 95% CI values of the GHOST-EU trial were adapted from [8] and of the ABSORB trials were adapted from [10]. * Predictive values and likelihood ratio for GHOST-EU is calculated at 1-year and for ABSORB trials at 3-years. DoCE and TLF are defined in Table 2. HR: Hazzard ratio; CI: Confidence Interval; DoCE: device-oriented composite endpoint; TLF: Target Lesion Failure.

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  Figure 3. Risk factors to be considered for deciding to whom prolong dual-antiplatelet therapy following bioresorbable scaffold implantation. * Prasugrel and ticagrelor should be preferred over clopidogrel in ACS. † Complex procedures include ACC/AHA B2/C type lesions, >1 BRS implanted, or any other unfavorable clinical, angiographic, and procedural characteristics. ‡ Assessed by quantitative coronary angiography after PCI.4 § More intense regiment of DAPT could be considered in stable coronary artery disease patients: prasugrel/ticagrelor plus aspirin for 1-month, then de-escalation to clopidogrel plus aspirin [14]. DAPT: dual antiplatelet therapy; DoCE: device-oriented composite endpoint; MI: myocardial infarction; PCI: percutaneous coronary intervention; ACS: acute coronary syndrome; LEVF: left ejection ventricular fraction; MLD: minimum lumen diameter.