Key result
Imaging-guided Absorb BVS implantation shows ~29% 10-year major cardiovascular events with zero scaffold thrombosis.
Why the study?
Coronary implantation of the Absorb bioresorbable vascular scaffold (BVS) without intravascular imaging (IVI) guidance resulted in greater adverse events compared with metallic drug-eluting stents over 3 years, motivating an evaluation of 10-year outcomes with routine IVI guidance.
Does routine intravascular imaging guidance improve 10-year clinical outcomes in patients undergoing coronary Absorb bioresorbable vascular scaffold implantation?
Observational (n=100)
No
Does routine intravascular imaging guidance improve 10-year clinical outcomes in patients undergoing coronary Absorb bioresorbable vascular scaffold implantation?
Routine intravascular imaging guidance during Absorb bioresorbable vascular scaffold implantation yielded favorable 10-year outcomes with zero cardiac deaths or definite scaffold thromboses, suggesting imaging optimization may mitigate long-term BVS risks.
Answers are grounded in this paper and cite their sources.
Supports IVI-guided BVS evaluation; hypothesis-generating and should not change practice pending RCTs.
BACKGROUND: Coronary artery implantation of the absorb bioresorbable vascular scaffold (BVS) without intravascular imaging (IVI) guidance resulted in greater adverse events compared with metallic drug-eluting stents during 3-year follow-up. AIMS: We assessed the 10-year outcomes of BVS implanted with routine use of IVI guidance. METHODS: Between November 2014 and October 2016, 100 consecutive patients in whom the operator elected to implant a BVS were treated with 190 BVS devices in 171 lesions at a single center in Brazil. IVI was performed before and after BVS implantation in all patients. Clinical follow-up was complete in all patients (no losses to follow-up) for at least 8.8 years. RESULTS: Median follow-up was 9.5 years (25th percentile 9.2, 75th percentile 10.1), range 8.8-10.8 years. Through the latest follow-up, no patient experienced a cardiac death or definite scaffold thrombosis, and only one patient had a target-vessel MI (TVMI). Major adverse cardiac events (the composite of all-cause death, any MI, or any revascularization) occurred in 29 patients (Kaplan-Meier estimated 10-year rate 29.4%); target vessel failure (TVF) (the composite of cardiac death, TVMI, or ischemia-driven target-vessel revascularization) occurred in 15 patients (10-year rate 15.0%); and target lesion failure (the composite of cardiac death, TVMI, or ischemia-driven target-lesion revascularization) occurred in 10 patients (10-year rate 10.0%). In the landmark analysis, TVF between 3 and 10 years occurred in 7 patients (7.6%). CONCLUSIONS: In this single-center, non-randomized observational study, the long-term outcomes of BVS implantation in simple and complex coronary lesions with routine IVI guidance were favorable. These findings are hypothesis-generating and require confirmation in adequately powered randomized studies.
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Costantini et al. (2026) conducted an observational in Coronary artery disease (n=100). Absorb bioresorbable vascular scaffold (BVS) implantation with routine intravascular imaging (IVI) guidance was evaluated on Major adverse cardiac events (all-cause death, any MI, or any revascularization), target vessel failure (cardiac death, target-vessel MI, or ischemia-driven target-vessel revascularization), and target lesion failure (cardiac death, target-vessel MI, or ischemia-driven target-lesion revascularization). Absorb BVS implantation with routine intravascular imaging guidance resulted in 10-year rates of 29.4% for major cardiovascular events, 15.0% for target vessel failure, and 0% for cardiac death or scaffold thrombosis.
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