October 1, 2012Open Access
View Full PaperFirst Serial Assessment at 6 Months and 2 Years of the Second Generation of Absorb Everolimus-Eluting Bioresorbable Vascular Scaffold
Key Result
The second-generation Absorb everolimus-eluting bioresorbable vascular scaffold showed a 2-year major adverse cardiac event rate of 6.8% with no scaffold thrombosis and 99% neointimal coverage.
Structured PICO
Does the second generation everolimus-eluting bioresorbable vascular scaffold show favorable imaging outcomes and safety at 6 and 24 months?
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Population
45 patients undergoing serial invasive imaging (quantitative coronary angiography, intravascular ultrasound, and optical coherence tomography) at 6 and 24 months of follow-up
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Intervention
Second generation everolimus-eluting bioresorbable vascular scaffold
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Outcome
Serial invasive imaging outcomes (late luminal loss, neointima, scaffold area) and major adverse cardiac events at 6 and 24 monthssurrogate
The second-generation everolimus-eluting bioresorbable vascular scaffold demonstrated favorable imaging outcomes with signs of bioresorption, increased scaffold area, and low MACE rates without scaffold thrombosis at 2 years.
Abstract
BACKGROUND: Nonserial observations have shown this bioresorbable scaffold to have no signs of area reduction at 6 months and recovery of vasomotion at 1 year. Serial observations at 6 months and 2 years have to confirm the absence of late restenosis or unfavorable imaging outcomes. METHODS AND RESULTS: The ABSORB trial is a multicenter single-arm trial assessing the safety and performance of an everolimus-eluting bioresorbable vascular scaffold. Forty-five patients underwent serial invasive imaging, such as quantitative coronary angiography, intravascular ultrasound, and optical coherence tomography at 6 and 24 months of follow-up. From 6 to 24 months, late luminal loss increased from 0.16±0.18 to 0.27±0.20 mm on quantitative coronary angiography, with an increase in neointima of 0.68±0.43 mm(2) on optical coherence tomography and 0.17±0.26 mm(2) on intravascular ultrasound. Struts still recognizable on optical coherence tomography at 2 years showed 99% of neointimal coverage with optical and ultrasonic signs of bioresorption accompanied by increase in mean scaffold area compared with baseline (0.54±1.09 mm(2) on intravascular ultrasound, P=0.003 and 0.77±1.33 m(2) on optical coherence tomography, P=0.016). Two-year major adverse cardiac event rate was 6.8% without any scaffold thrombosis. CONCLUSIONS: This serial analysis of the second generation of the everolimus-eluting bioresorbable vascular scaffold confirmed, at medium term, the safety and efficacy of the new device. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00856856.