scholarly journals Reduction of Lipid-Core Burden Index in Nonculprit Lesions at Follow-Up after ST-Elevation Myocardial Infarction: A Randomized Study of Bioresorbable Vascular Scaffold versus Optimal Medical Therapy

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Joelle Kefer ◽  
Patrick Chenu ◽  
Olivier Gurné ◽  
Frederic Maes ◽  
Théophile Tamakloé ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Medical Therapy ◽  
St Elevation Myocardial Infarction ◽  
Plaque Burden ◽  
Bioresorbable Vascular Scaffold ◽  
Vascular Scaffold ◽  
St Elevation ◽  
Group 2 ◽  
Group 1

Background. Non-flow-limiting nonculprit lesions (NCL) that contain a large lipid-rich necrotic core (nonculprit lipid-rich plaques (NC-LRP)) are most likely to cause recurrent acute coronary syndrome after ST-elevation myocardial infarction (STEMI). Near-infrared spectroscopy (NIRS) detects LRPs using the maximum 4 mm lipid-core burden index (maxLCBI4 mm). Few data are available regarding NIRS-guided therapy of these NC-LRPs, which are a potential target for preventive stenting. Bioresorbable vascular scaffold (BVS) provides local drug delivery and could facilitate plaque passivation after resorption. This study sought to assess the safety of BVS implantation in NC-LRPs and its efficacy in reducing maxLCBI4 mm at 2-year follow-up after STEMI. Methods and Results. In total, 33 non-flow-limiting NCLs from 29 STEMI patients were included in this study. Of these, 15 were LRPs and were randomly assigned to either the BVS + optimal medical therapy (OMT) arm (group 1; N = 7) or the OMT arm (group 2; N = 8). At baseline, there were no differences in plaque characteristics between groups (fractional flow reserve: 0.85 ± 0.04 vs. 0.89 ± 0.06; diameter stenosis (DS): 43.4 ± 8 vs. 40.1 ± 10.7%; plaque burden 54.98 ± 5.8 vs. 49.76 ± 8.31%; and maxLCBI4 mm 402 [348; 564] vs. 373 [298; 516]; p = N S for all comparisons between groups 1 and 2, respectively). Seven BVSs were implanted 3 ± 1 days after STEMI in six patients, without complications. At angiographic follow-up (712 [657; 740] days), a significant and similar reduction of maxLCBI4 mm was observed in both groups, with a median change of 306 [257; 377] in group 1 vs. 300 [278; 346] in group 2 p = 0.44 . DS was significantly lower in group 1 vs. group 2 (19.8 ± 7 vs. 41.7 ± 13%, p = 0.003 ), while plaque burden remained unchanged in both groups. Overall survival was 100%, target lesion failure was 13%, and stent thrombosis was 0%. Conclusions. BVS + OMT and OMT appear as similarly safe and effective in reducing maxLCBI4mm in NC-LRPs at 2-year follow-up after STEMI.

Bioresorbable vascular scaffold for ST elevation myocardial infarction

2015 ◽  
Vol 26 (6) ◽  
pp. 545-547
Author(s):  
Jiang Ming Fam ◽  
Antonios Karanasos ◽  
Evelyn Regar ◽  
Robert-Jan van Geuns
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Bioresorbable Vascular Scaffold ◽  
Vascular Scaffold ◽  
St Elevation

scholarly journals ST elevation myocardial infarction treated with bioresorbable vascular scaffold: rationale and first cases

2013 ◽  
Vol 34 (27) ◽  
pp. 2073-2073 ◽  
Author(s):  
Viktor Kočka ◽  
Libor Lisa ◽  
Petr Toušek ◽  
Tomáš Buděšínský ◽  
Petr Widimský
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Bioresorbable Vascular Scaffold ◽  
Vascular Scaffold ◽  
St Elevation

SOLELY INFARC-RELATED ARTERY VERSUS STAGED PERCUTANEOUS CORONARY INTERVENTION IN ST ELEVATION MYOCARDIAL INFARCTION PATIENTS WITH MULTIVESSEL CORONARY DISEASE

2014 ◽  
pp. 56-62
Author(s):  
Anh Tuan Ho ◽  
Van Dien Nguyen ◽  
Anh Tien Hoang
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Bypass Graft ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Percutaneous Coronary ◽  
Infarct Related Artery ◽  
St Elevation ◽  
Group 2 ◽  
Group 1

Today, there are different interventional approaches for patients undergoing ST elevation myocardial infarction (STEMI) with multiple vessel diseases. Objectives: to compare the mid-term results of two strategies of myocardial revascularization used for the management of patients with STEMI with multiple vessel diseases. Material and methods: we analyzed retrogradely 64 profiles of patients diagnosed STEMI with multiple vessel diseases on coronary angiography and underwent angioplasty in Cardiovascular department from 5/2013 – 1/2014. The patients had been divided into 2 groups: group 1 (percutaneous coronary intervention (PCI) of the sole Infarct-related artery followed by medical therapy, n=33) and group 2 (staged PCI in STEMI patients with multiple vessel diseases, n=31). Results: group 2 had comparable combined end-points (death + Myocardial infarction + revascularization) rate but higher rate of detection of significantly stenosed non-culprit vessels than those of group 1. Conclusion: for the STEMI patients with multiple vessel diseases admitted to Hue University hospital, staged PCI was better than PCI of the sole infarct-related artery in term of omitting less patients who were appropriate for revascularization (these patients had no indication for coronary artery bypass graft). However, these two approaches had no statistical difference regarding to major adverse cardiac events. Key words: Acute myocardial infarction, Multivessel disease, Primary percutaneous coronary intervention

Bioresorbable Vascular Scaffold During ST-Elevation Myocardial Infarction: A Systematic Review

2017 ◽  
Vol 33 (4) ◽  
pp. 515-524 ◽  
Author(s):  
Fabien Picard ◽  
Quentin de Hemptinne ◽  
Robert Avram ◽  
Hung Q. Ly ◽  
Philippe L. L'Allier ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Systematic Review ◽  
St Elevation Myocardial Infarction ◽  
Bioresorbable Vascular Scaffold ◽  
Vascular Scaffold ◽  
St Elevation

Long-term outcomes of bioresorbable vascular scaffold in ST-elevation myocardial infarction

2017 ◽  
Vol 73 (3) ◽  
pp. 276-281
Author(s):  
Quentin de Hemptinne ◽  
Fabien Picard ◽  
Hung Q. Ly ◽  
Reda Ibrahim ◽  
Anita W. Asgar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Long Term Outcomes ◽  
Bioresorbable Vascular Scaffold ◽  
Vascular Scaffold ◽  
St Elevation

Early vascular responses to ultrathin biodegradable polymer sirolimus-eluting stent for the treatment of st-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Oishi ◽  
T Shinke ◽  
H Tanaka ◽  
K Ogura ◽  
K Arai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Antiplatelet Therapy ◽  
St Elevation Myocardial Infarction ◽  
Current Generation ◽  
Vascular Responses ◽  
Post Procedure ◽  
St Elevation ◽  
Sirolimus Eluting Stent

Abstract Background Recent clinical study suggests newer-generation drug-eluting stents (DES) that combine ultrathin strut and nano-coating with biodegradable polymers sirolimus-eluting stent (BP-SES) could improve long-term clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) over current generation DES. However, safety profiles in very early phase have not been systematically addressed. Objective and method We exploratory investigate early vascular response following BP-SES implantation in patients with STEMI to reveal mechanism of the favorable clinical outcomes in recent studies using frequency domain-optical coherence tomography (FD-OCT). Consecutive twenty patients with STEMI who underwent FD-OCT immediately after primary PCI and were eligible for follow-up FD-OCT at 2 weeks after implantation were enrolled between June 2018 and November 2019. Results Twenty patients (age 62.7±11.3 years, male 85.0%) were enrolled with frequencies of hypertension (45.0%), diabetes mellitus (35.0%), dyslipidemia (55.0%) and smoking (80.0%). Aspiration catheter were used in all patients, and 1.13±0.34 stents were used. Only one patient (5.0%) received chronic antiplatelet therapy with aspirin prior to the onset of STEMI. All patients started to receive prasugrel as thienopyridine from this event and continued dual antiplatelet therapy for 2 weeks. The percentage of uncovered struts significantly decreased from post-procedure to 2W follow-up (69±18% post-procedure versus 30±11% at 2W follow up, p<0.0001). Malapposed struts also decreased (5.6±5.7% post-procedure versus0.9±1.2% at 2W follow up, p<0.0001).The average protrusion area of athero-thrombotic burden numerically decreased (0.37±0.19 at post-procedure versus 0.34±0.14 mm2 at 2W follow up, p=0.19) and its volume showed similar tendency (10.60±6.40 at post-procedure versus 9.36±5.14 mm3 at 2W follow up, p=0.19). Conclusion(s) This study firstly elucidated very early vascular responses following ultrathin strut BP-SES implantation in STEMI patients, showing early progression of strut coverage and resolution of athero-thrombotic materials. This technology may have a potential to overcome the current generation DESs in this clinical setting. Thrombus, uncovered and malapposed struts Funding Acknowledgement Type of funding source: None

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