계명대학교 의학도서관 Repository

Safety and Efficacy of Everolimus-Eluting Bioresorbable Vascular Scaffold Versus Second-Generation Drug-Eluting Stents in Real-World Practice

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Author(s)
Joo Myung LeeHyun Sung JohKi Hong ChoiDavid HongTaek Kyu ParkJeong Hoon YangYoung Bin SongJin-Ho ChoiSeung-Hyuk ChoiJin-Ok JeongJong-Young LeeYoung Jin ChoiJei-Keon ChaeSeung-Ho HurJang-Whan BaeJu-Hyeon OhKook-Jin ChunHyun-Joong KimByung Ryul ChoDoosup ShinSeung Hun LeeDoyeon HwangHyun-Jong LeeHo-Jun JangHyun Kuk KimSang Jin HaEun-Seok ShinJoon-Hyung DohJoo-Yong HahnHyeon-Cheol Gwon
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Korean Med Sci
Issued Date
2023
Volume
38
Issue
5
Keyword
Bioresorbable Vascular Scaffold (BVS)Drug-Eluting Stent (DES)EfficacySafety
Abstract
Background:
The risk of device thrombosis and device-oriented clinical outcomes with bioresorbable vascular scaffold (BVS) was reported to be significantly higher than with contemporary drug-eluting stents (DESs). However, optimal device implantation may improve clinical outcomes in patients receiving BVS. The current study evaluated mid-term safety and efficacy of Absorb BVS with meticulous device optimization under intravascular imaging guidance.

Methods:
The SMART-REWARD and PERSPECTIVE-PCI registries in Korea prospectively enrolled 390 patients with BVS and 675 patients with DES, respectively. The primary endpoint was target vessel failure (TVF) at 2 years and the secondary major endpoint was patient-oriented composite outcome (POCO) at 2 years.

Results:
Patient-level pooled analysis evaluated 1,003 patients (377 patients with BVS and 626 patients with DES). Mean scaffold diameter per lesion was 3.24 ± 0.30 mm in BVS group. Most BVSs were implanted with pre-dilatation (90.9%), intravascular imaging guidance (74.9%), and post-dilatation (73.1%) at proximal to mid segment (81.9%) in target vessel. Patients treated with BVS showed comparable risks of 2-year TVF (2.9% vs. 3.7%, adjusted hazard ratio [HR], 1.283, 95% confidence interval [CI], 0.487-3.378, P = 0.615) and 2-year POCO (4.5% vs. 5.9%, adjusted HR, 1.413, 95% CI, 0.663-3.012, P = 0.370) than those with DES. The rate of 2-year definite or probable device thrombosis (0.3% vs. 0.5%, P = 0.424) was also similar. The sensitivity analyses consistently showed comparable risk of TVF and POCO between the 2 groups.

Conclusion:
With meticulous device optimization under imaging guidance and avoidance of implantation in small vessels, BVS showed comparable risks of 2-year TVF and device thrombosis with DES.

Trial registration:
ClinicalTrials.gov Identifier: NCT02601404, NCT04265443.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1598-6357
Source
https://jkms.org/DOIx.php?id=10.3346/jkms.2023.38.e34
DOI
10.3346/jkms.2023.38.e34
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44855
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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