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OPTICAL COHERENCE TOMOGRAPHY ASSESSMENT OF THE 5-YEAR VASCULAR HEALING RESPONSE FOLLOWING...

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TCT@ACC-i2: The Interventional Learning Pathway A1883 JACC April 1, 2014 Volume 63, Issue 12 OPTICAL COHERENCE TOMOGRAPHY ASSESSMENT OF THE 5-YEAR VASCULAR HEALING RESPONSE FOLLOWING IMPLANTATION OF THE EVEROLIMUS-ELUTING BIORESORBABLE VASCULAR SCAFFOLD. Poster Contributions Hall C Monday, March 31, 2014, 9:45 a.m.-10:30 a.m. Session Title: Bioresorbable and Drug-Eluting Balloon Technologies Abstract Category: 41. TCT@ACC-i2: Coronary Intervention: Devices Presentation Number: 2109-282 Authors: Antonios Karanasos, Muthukaruppan Gnanadesigan, Nienke van Ditzhuijzen, cihan simsek, Raphael Freire, Jouke Dijkstra, Gijs Van Soest, Felix Zijlstra, Robert van Geuns, Evelyn Regar, Erasmus Medical Center, Rotterdam, The Netherlands Background: The in vivo long-term vascular response after bioresorbable vascular scaffold (BVS) implantation remains elusive. We assessed the healing response 5 years after elective BVS implantation by optical coherence tomography (OCT). Methods: Eight of 14 living patients enrolled in the Thoraxcenter cohort of the ABSORB A study, underwent additional OCT follow-up, 5 years post BVS implantation. OCT analysis included luminal morphometry, quantification of the sealing layer (figure) separating the lumen from underlying plaque components, and qualitative and quantitative characterization of the neo-plaque. Results. In all patients, both minimum and mean luminal area were increased from 2 years to 5 years, while lumen eccentricity was reduced over time. All struts were integrated into the wall, and in the majority of patients, plaques were covered by a signal-rich, low-attenuating sealing layer. In 2 cases, irregularities of the sealing layer were observed. The median value for mean sealing layer thickness was 330μm. Necrotic core-containing regions were found in all patients. The minimum cap thickness over necrotic core was 155±90μm and maximum necrotic core arc was 156±72°. Conclusions: At long-term BVS follow-up, a favorable tissue response is observed, with late lumen enlargement and development of a signal- rich, low-attenuating ‘sealing layer’ shielding plaque components. The finding of 2 patients with focal sealing layer irregularities warrants caution in generalization of our results.
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Page 1: OPTICAL COHERENCE TOMOGRAPHY ASSESSMENT OF THE 5-YEAR VASCULAR HEALING RESPONSE FOLLOWING IMPLANTATION OF THE EVEROLIMUS-ELUTING BIORESORBABLE VASCULAR SCAFFOLD

TCT@ACC-i2: The Interventional Learning Pathway

A1883JACC April 1, 2014

Volume 63, Issue 12

oPticAl coherence toMogrAPhy AssessMent of the 5-yeAr VAsculAr heAling resPonse folloWing iMPlAntAtion of the eVeroliMus-eluting bioresorbAble VAsculAr scAffolD.

Poster ContributionsHall CMonday, March 31, 2014, 9:45 a.m.-10:30 a.m.

Session Title: Bioresorbable and Drug-Eluting Balloon TechnologiesAbstract Category: 41. TCT@ACC-i2: Coronary Intervention: DevicesPresentation Number: 2109-282

Authors: Antonios Karanasos, Muthukaruppan Gnanadesigan, Nienke van Ditzhuijzen, cihan simsek, Raphael Freire, Jouke Dijkstra, Gijs Van Soest, Felix Zijlstra, Robert van Geuns, Evelyn Regar, Erasmus Medical Center, Rotterdam, The Netherlands

background: The in vivo long-term vascular response after bioresorbable vascular scaffold (BVS) implantation remains elusive. We assessed the healing response 5 years after elective BVS implantation by optical coherence tomography (OCT).

Methods: Eight of 14 living patients enrolled in the Thoraxcenter cohort of the ABSORB A study, underwent additional OCT follow-up, 5 years post BVS implantation. OCT analysis included luminal morphometry, quantification of the sealing layer (figure) separating the lumen from underlying plaque components, and qualitative and quantitative characterization of the neo-plaque.

results. In all patients, both minimum and mean luminal area were increased from 2 years to 5 years, while lumen eccentricity was reduced over time. All struts were integrated into the wall, and in the majority of patients, plaques were covered by a signal-rich, low-attenuating sealing layer. In 2 cases, irregularities of the sealing layer were observed. The median value for mean sealing layer thickness was 330μm. Necrotic core-containing regions were found in all patients. The minimum cap thickness over necrotic core was 155±90μm and maximum necrotic core arc was 156±72°.

conclusions: At long-term BVS follow-up, a favorable tissue response is observed, with late lumen enlargement and development of a signal-rich, low-attenuating ‘sealing layer’ shielding plaque components. The finding of 2 patients with focal sealing layer irregularities warrants caution in generalization of our results.

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