Skip to main content
SpringerLink
Log in

Implications of a bioresorbable vascular scaffold implantation on vessel wall strain of the treated and the adjacent segments

  • Original Paper
  • Published:
The International Journal of Cardiovascular Imaging Aims and scope Submit manuscript

Abstract

Background Metallic stents change permanently the mechanical properties of the vessel wall. However little is known about the implications of bioresorbable vascular scaffolds (BVS) on the vessel wall strain. Methods Patients (n = 53) implanted with an Absorb BVS that had palpographic evaluation at any time point [before device implantation, immediate after treatment, at short-term (6–12 months) or mid-term follow-up (24–36 months)] were included in the current analysis. The palpographic data were used to estimate the mean of the maximum strain values and the obtained measurements were classified using the Rotterdam classification (ROC) score and expressed as ROC/mm. Results Scaffold implantation led to a significant decrease of the vessel wall strain in the treated segment [0.35 (0.20, 0.38) vs. 0.19 (0.09, 0.29); P = 0.005] but it did not affect the proximal and distal edge. In patients who had serial palpographic examination the vessel wall strain continued to decrease in the scaffolded segment at short-term [0.20 (0.12, 0.29) vs. 0.14 (0.08, 0.20); P = 0.048] and mid-term follow-up [0.20 (0.12, 0.29) vs. 0.15 (0.10, 0.19), P = 0.024]. No changes were noted with time in the mechanical properties of the vessel wall at the proximal and distal edge. Conclusions Absorb BVS implantation results in a permanent alteration of the mechanical properties of the vessel wall in the treated segment. Long term follow-up data are needed in order to examine the clinical implications of these findings.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Schaar JA, Regar E, Mastik F et al (2004) Incidence of high-strain patterns in human coronary arteries: assessment with three-dimensional intravascular palpography and correlation with clinical presentation. Circulation 109(22):2716–2719

    Article  PubMed  Google Scholar 

  2. Schaar JA, De Korte CL, Mastik F et al (2003) Characterizing vulnerable plaque features with intravascular elastography. Circulation 108(21):2636–2641

    Article  PubMed  Google Scholar 

  3. de Korte CL, Sierevogel MJ, Mastik F et al (2002) Identification of atherosclerotic plaque components with intravascular ultrasound elastography in vivo: a Yucatan pig study. Circulation 105(14):1627–1630

    Article  PubMed  Google Scholar 

  4. Brugaletta S, Garcia-Garcia HM, Serruys PW et al (2012) Relationship between palpography and virtual histology in patients with acute coronary syndromes. JACC Cardiovasc Imaging 5(3Suppl):S19–S27

    Article  PubMed  Google Scholar 

  5. Serruys PW, Ormiston JA, Onuma Y et al (2009) Abioabsorbable everolimus-eluting coronary stent system (ABSORB): 2-year outcomes and results from multiple imaging methods. Lancet 373(9667):897–910

    Article  CAS  PubMed  Google Scholar 

  6. Brugaletta S, Gogas BD, Garcia-Garcia HM et al (2012) Vascular compliance changes of the coronary vessel wall after bioresorbable vascular scaffold implantation in the treated and adjacent segments. Circ J 76(7):1616–1623

    Article  PubMed  Google Scholar 

  7. Van Mieghem CA, McFadden EP, de Feyter PJ et al (2006) Noninvasive detection of subclinical coronary atherosclerosis coupled with assessment of changes in plaque characteristics using novel invasive imaging modalities: the integrated biomarker and imaging study (IBIS). J Am Coll Cardiol 47(6):1134–1142

    Article  PubMed  Google Scholar 

  8. Serruys PW, Garcia-Garcia HM, Buszman P et al (2008) Effects of the direct lipoprotein-associated phospholipase A(2) inhibitor darapladib on human coronary atherosclerotic plaque. Circulation 118(11):1172–1182

    Article  CAS  PubMed  Google Scholar 

  9. Wykrzykowska JJ, Diletti R, Gutierrez-Chico JL et al (2012) Plaque sealing and passivation with a mechanical self-expanding low outward force nitinol vShield device for the treatment of IVUS and OCT-derived thin cap fibroatheromas (TCFAs) in native coronary arteries: report of the pilot study vShield Evaluated at Cardiac hospital in Rotterdam for Investigation and Treatment of TCFA (SECRITT). EuroIntervention 8(8):945–954

    Article  PubMed  Google Scholar 

  10. Serruys PW, Onuma Y, Ormiston JA et al (2010) Evaluation of the second generation of a bioresorbable everolimus drug-eluting vascular scaffold for treatment of de novo coronary artery stenosis: six-month clinical and imaging outcomes. Circulation 122(22):2301–2312

    Article  CAS  PubMed  Google Scholar 

  11. Schaar JA, van der Steen AF, Mastik F et al (2006) Intravascular palpography for vulnerable plaque assessment. J Am Coll Cardiol 47(8 Suppl):C86–C91

    Article  PubMed  Google Scholar 

  12. Garcia-Garcia HM, Gonzalo N, Pawar R et al (2009) Assessment of the absorption process following bioabsorbable everolimus-eluting stent implantation: temporal changes in strain values and tissue composition using intravascular ultrasound radiofrequency data analysis. A substudy of the ABSORB clinical trial. EuroIntervention 4(4):443–448

    Article  PubMed  Google Scholar 

  13. Tanimoto S, Bruining N, van Domburg RT (2008) Late stent recoil of the bioabsorbable everolimus-eluting coronary stent and its relationship with plaque morphology. J Am Coll Cardiol 52(20):1616–1620

    Article  CAS  PubMed  Google Scholar 

  14. Gomez-Lara J, Brugaletta S, Diletti R et al (2011) A comparative assessment by optical coherence tomography of the performance of the first and second generation of the everolimus-eluting bioresorbable vascular scaffolds. Eur Heart J 32(3):294–304

    Article  CAS  PubMed  Google Scholar 

  15. Serruys PW, Onuma Y, Dudek D et al (2011) Evaluation of the second generation of a bioresorbable everolimus-eluting vascular scaffold for the treatment of de novo coronary artery stenosis: 12-month clinical and imaging outcomes. J Am Coll Cardiol 58(15):1578–1588

    Article  CAS  PubMed  Google Scholar 

  16. Brugaletta S, Radu MD, Garcia-Garcia HM et al (2012) Circumferential evaluation of the neointima by optical coherence tomography after ABSORB bioresorbable vascular scaffold implantation: can the scaffold cap the plaque? Atherosclerosis 221(1):106–112

    Article  CAS  PubMed  Google Scholar 

  17. Onuma Y, Serruys PW, Perkins LE et al (2010) Intracoronary optical coherence tomography and histology at 1 month and 2, 3, and 4 years after implantation of everolimus-eluting bioresorbable vascular scaffolds in a porcine coronary artery model: an attempt to decipher the human optical coherence tomography images in the ABSORB trial. Circulation 122(22):2288–2300

    Article  CAS  PubMed  Google Scholar 

  18. Peng X, Haldar S, Deshpande S et al (2003) Wall stiffness suppresses Akt/eNOS and cytoprotection in pulse-perfused endothelium. Hypertension 41(2):378–381

    Article  CAS  PubMed  Google Scholar 

  19. Gupta V, Grande-Allen KJ (2006) Effects of static and cyclic loading in regulating extracellular matrix synthesis by cardiovascular cells. Cardiovasc Res 72(3):375–383

    Article  CAS  PubMed  Google Scholar 

  20. Schad JF, Meltzer KR, Hicks MR et al (2011) Cyclic strain upregulates VEGF and attenuates proliferation of vascular smooth muscle cells. Vasc Cell 3:21

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Stone GW, Maehara A, Lansky AJ et al (2011) A prospective natural-history study of coronary atherosclerosis. N Engl J Med 364(3):226–235

    Article  CAS  PubMed  Google Scholar 

  22. Serruys PW, Garcia-Garcia HM, Onuma Y (2012) From metallic cages to transient bioresorbable scaffolds: change in paradigm of coronary revascularization in the upcoming decade? Eur Heart J 33(1):16–25

    Article  PubMed  Google Scholar 

  23. Bourantas CV, Farooq V, Zhang Y, et al. (2013) Circumferential distribution of the neointima at 6 months and 2 years follow-up after a bioresorbable vascular scaffold implantation. A substudy of the ABSORB Cohort B Clinical Trial EuroIntervention (In press)

  24. Stone GW (2013) Rationale and design of PROSPECT II. 11 Vulnerable Plaque Meeting, Paris, France, 23–26 June 2013

  25. Imoto K, Hiro T, Fujii T et al (2005) Longitudinal structural determinants of atherosclerotic plaque vulnerability: a computational analysis of stress distribution using vessel models and three-dimensional intravascular ultrasound imaging. J Am Coll Cardiol 46(8):1507–1515

    Article  PubMed  Google Scholar 

  26. Kumar RK, Balakrishnan KR (2005) Influence of lumen shape and vessel geometry on plaque stresses: possible role in the increased vulnerability of a remodelled vessel and the “shoulder” of a plaque. Heart 91(11):1459–1465

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

Christos V. Bourantas is funded by the Hellenic Heart Foundation.

Conflict of interest

Xingyu Gao is employee of Abbott Vascular. None of the other authors have any conflict of interest to declare.

Author information

Authors and Affiliations

  1. Interventional Cardiology Department, Thoraxcenter, Erasmus Medical Center, ‘s-Gravendijkwal 230, 3015, CE, Rotterdam, The Netherlands

    Christos V. Bourantas, Hector M. Garcia-Garcia, Carlos A. M. Campos, Yao-Jun Zhang, Takashi Muramatsu, Marie-Angèle Morel, Shimpei Nakatani, Yun-Kyeong Cho, Yuki Isibashi, Frank J. H. Gijsen, Yoshinobu Onuma & Patrick W. Serruys

  2. Abbott Vascular, Santa Clara, CA, USA

    Xingyu Gao

Authors
  1. Christos V. Bourantas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hector M. Garcia-Garcia
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Carlos A. M. Campos
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yao-Jun Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takashi Muramatsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Marie-Angèle Morel
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Shimpei Nakatani
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Xingyu Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Yun-Kyeong Cho
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Yuki Isibashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Frank J. H. Gijsen
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Yoshinobu Onuma
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Patrick W. Serruys
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Patrick W. Serruys.

Additional information

On behalf of the Absorb Cohort B Investigators.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOC 2553 kb)

Supplementary material 2 (DOC 602 kb)

Rights and permissions

Reprints and permissions

About this article

Cite this article

Bourantas, C.V., Garcia-Garcia, H.M., Campos, C.A.M. et al. Implications of a bioresorbable vascular scaffold implantation on vessel wall strain of the treated and the adjacent segments. Int J Cardiovasc Imaging 30, 477–484 (2014). https://doi.org/10.1007/s10554-014-0373-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10554-014-0373-4

Keywords

Search

Navigation