Primary PCI with Bioresorbable Vascular Scaffolds

Original Title: One-year Clinical and Computed Tomography Angiographic Outcomes after Bioresorbable Vascular Scaffold Implantation during Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction. The Prague-19 Study. Reference: Widimsky P et al. Circ Cardiovasc Interv. 2015 Dec;8(12).

Courtesy of Dr. Carlos Fava.

Primary PCI is the most common course of treatment for ST elevation myocardial infarction (STEMI) but the role of bioresorbable scaffolds (BVS) in this context remains unclear.

This prospective study included 70 STEMI patients undergoing primary PCI with BVS. Three patients could not receive BVS and got a bare metal stent instead.

At 30 days, there was definite thrombosis of BVS in a patient that had stopped DAPT and one death for a mechanical complication of infarction. At one year, there was one case of restenosis and a sudden death.

After 1 year, computed tomographic angiography performed in 59 patients showed binary restenosis rate of 2% and minimal luminal diameter of 3.0±0.6 mm.

Conclusion
The use of bioresorbable scaffold in the context of STEMI is feasible and safe, and offers excellent clinical and angiographic evolution at one year.

Editorial Comment
This study shows that the use of these new devices is favorable in complex scenarios such as PCI, with the advantage of recovering vessel physiology in time. At present, BVS present certain limitations, such as the limited choice of size, apart from the need of vessel preparation before implantation.

Courtesy of Dr. Carlos Fava.
Cardiólogo Intervencionista
Fundación Favaloro – Buenos Aires

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