Lesion impacts on long-term outcomes in patients implanted with bioresorbable vascular scaffold
Background: Bioresorbable vascular scaffold (BVS) had been implanted to several kinds of complex coronary lesions in real-world practice. We tested if long-term outcomes of BVS for complex lesions would be worse than that for relatively simple lesions. Methods: We analyzed 457 patients (59 ± 12 year...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-08-01
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| Series: | Journal of the Formosan Medical Association |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664621004848 |
| _version_ | 1818194171300675584 |
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| author | Yi-Chih Wang Hsien-Li Kao Cho-Kai Wu Mao-Shin Lin Fu-Tien Chiang Juey-Jen Hwang |
| author_facet | Yi-Chih Wang Hsien-Li Kao Cho-Kai Wu Mao-Shin Lin Fu-Tien Chiang Juey-Jen Hwang |
| author_sort | Yi-Chih Wang |
| collection | DOAJ |
| description | Background: Bioresorbable vascular scaffold (BVS) had been implanted to several kinds of complex coronary lesions in real-world practice. We tested if long-term outcomes of BVS for complex lesions would be worse than that for relatively simple lesions. Methods: We analyzed 457 patients (59 ± 12 years, 87% male) with 714 BVS implanted for their 529 lesions and median follow-up of 32.7 (26.8–39.3) months. Complex group (N = 284) was defined as those with BVS for acute coronary syndrome, chronic total occlusion, bifurcation/ostial lesions, instent restenosis/hybrid with metallic stents, diffuse lesions (overlapped by 2 BVS with each ≧ 18 mm), venous graft/left main lesions, or lesions after rotablation. We compared their outcomes with the remaining 173 patients as non-complex group. Results: The complex group had more chronic kidney disease (7% vs. 2%), multivessel disease (78% vs. 65%), use of intravascular imaging (40% vs. 23%), and more BVS (1.8 ± 0.9 vs. 1.1 ± 0.3) with longer total lengths (47 ± 22 vs. 29 ± 8 mm) implanted than non-complex group (all p < 0.05). However, the long-term target lesion revascularization (TLR) or target lesion failure (TLF) was similar (log rank p > 0.05) between the two groups. Multivariate Cox regression analyses showed BVS for ACC/AHA type C lesions was independently associated with higher risks of TLR (hazard ratio: 2.7, 95% CI = 1.1–6.6) and TLF (hazard ratio: 2.6, 95% CI = 1.1–6.3). Conclusion: Comparable outcomes were found between BVS for complex and non-complex lesion category. However, higher risks of TLR and TLF for type C lesions still suggested the prognostic impact of lesion complexity on long-term outcomes of BVS. |
| first_indexed | 2024-12-12T00:58:03Z |
| format | Article |
| id | doaj.art-0c6237071ee24da1836c8c227f7ed10f |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-12-12T00:58:03Z |
| publishDate | 2022-08-01 |
| publisher | Elsevier |
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| spelling | doaj.art-0c6237071ee24da1836c8c227f7ed10f2022-12-22T00:43:49ZengElsevierJournal of the Formosan Medical Association0929-66462022-08-01121814581465Lesion impacts on long-term outcomes in patients implanted with bioresorbable vascular scaffoldYi-Chih Wang0Hsien-Li Kao1Cho-Kai Wu2Mao-Shin Lin3Fu-Tien Chiang4Juey-Jen Hwang5Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanCardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanCardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanCardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanCardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanCorresponding author. Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.; Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, TaiwanBackground: Bioresorbable vascular scaffold (BVS) had been implanted to several kinds of complex coronary lesions in real-world practice. We tested if long-term outcomes of BVS for complex lesions would be worse than that for relatively simple lesions. Methods: We analyzed 457 patients (59 ± 12 years, 87% male) with 714 BVS implanted for their 529 lesions and median follow-up of 32.7 (26.8–39.3) months. Complex group (N = 284) was defined as those with BVS for acute coronary syndrome, chronic total occlusion, bifurcation/ostial lesions, instent restenosis/hybrid with metallic stents, diffuse lesions (overlapped by 2 BVS with each ≧ 18 mm), venous graft/left main lesions, or lesions after rotablation. We compared their outcomes with the remaining 173 patients as non-complex group. Results: The complex group had more chronic kidney disease (7% vs. 2%), multivessel disease (78% vs. 65%), use of intravascular imaging (40% vs. 23%), and more BVS (1.8 ± 0.9 vs. 1.1 ± 0.3) with longer total lengths (47 ± 22 vs. 29 ± 8 mm) implanted than non-complex group (all p < 0.05). However, the long-term target lesion revascularization (TLR) or target lesion failure (TLF) was similar (log rank p > 0.05) between the two groups. Multivariate Cox regression analyses showed BVS for ACC/AHA type C lesions was independently associated with higher risks of TLR (hazard ratio: 2.7, 95% CI = 1.1–6.6) and TLF (hazard ratio: 2.6, 95% CI = 1.1–6.3). Conclusion: Comparable outcomes were found between BVS for complex and non-complex lesion category. However, higher risks of TLR and TLF for type C lesions still suggested the prognostic impact of lesion complexity on long-term outcomes of BVS.http://www.sciencedirect.com/science/article/pii/S0929664621004848Bioresorbable vascular scaffoldLong-term outcomeLesion complexityACC/AHA lesion Classification |
| spellingShingle | Yi-Chih Wang Hsien-Li Kao Cho-Kai Wu Mao-Shin Lin Fu-Tien Chiang Juey-Jen Hwang Lesion impacts on long-term outcomes in patients implanted with bioresorbable vascular scaffold Journal of the Formosan Medical Association Bioresorbable vascular scaffold Long-term outcome Lesion complexity ACC/AHA lesion Classification |
| title | Lesion impacts on long-term outcomes in patients implanted with bioresorbable vascular scaffold |
| title_full | Lesion impacts on long-term outcomes in patients implanted with bioresorbable vascular scaffold |
| title_fullStr | Lesion impacts on long-term outcomes in patients implanted with bioresorbable vascular scaffold |
| title_full_unstemmed | Lesion impacts on long-term outcomes in patients implanted with bioresorbable vascular scaffold |
| title_short | Lesion impacts on long-term outcomes in patients implanted with bioresorbable vascular scaffold |
| title_sort | lesion impacts on long term outcomes in patients implanted with bioresorbable vascular scaffold |
| topic | Bioresorbable vascular scaffold Long-term outcome Lesion complexity ACC/AHA lesion Classification |
| url | http://www.sciencedirect.com/science/article/pii/S0929664621004848 |
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