Structural and Functional Evaluation of Coronary Arteries Treated With ABSORB Bioresorbable Vascular Scaffold at 5-Year Follow-Up

Although complete bioresorbable vascular scaffold (BVS) resorption has been demon-strated at 5-year follow-up, whether corresponding vasomotor function restoration occurs remains unknown. The objective was to simultaneously assess the structural healing response along with vasomotor responses at 5-year follow-up of BVS implantation. We studied consecutive patients treated with ABSORB-BVS at 5-year follow-up (n = 31), who were recruited from a multicenter registry and were contacted to undergo a research pro-tocol-driven repeat coronary angiogram involving intracoronary optical coherence tomog-raphy (OCT) and invasive coronary endothelial function testing. Epicardial endothelium -dependent vasomotion was defined as any vasodilatation after intracoronary acetylcholine (ACh), whereas endothelium-independent vasomotion was defined as any vasodilatation after intracoronary nitroglycerine (NTG), using quantitative coronary angiography. The mean implantation time point was 60.5 +/- 4.6 months. OCT imaging demonstrated com-plete scaffold resorption in all patients. New coronary lesions (stenosis >50%) were found in 5 patients (16.1%), 3 of them underwent ad hoc percutaneous revascularization (9.7%). Intracoronary ACh (27 patients) and NTG testing (30 patients) was performed. Quantita-tive coronary angiography analysis demonstrated vasoconstriction after ACh administra-tion and lack of response to NTG in BVS segments (mean lumen diameter = 2.00 +/- 0.61 mm at baseline vs 1.74 +/- 0.70 mm post-ACh, p <0.001; 2.05 +/- 0.54 mm at baseline vs 2.03 +/- 0.50 mm post-NTG, p = 0.69). OCT lumen analysis demonstrated similar vasocon-strictive responses to ACh (mean lumen area = 5.31 +/- 2.26 mm2 at baseline vs 5.12 +/- 2.55 mm2 post-ACh, p = 0.007) but had a vasodilatory response to NTG (5.96 +/- 2.35 mm2 at baseline vs 6.17 +/- 2.55 mm2 post-NTG, p<0.001). In conclusion, complete ABSORB-BVS resorption was demonstrated at 5-year follow-up. However, this healing response was associated with endothelium-dependent vasomotor dysfunction within the BVS seg-ment. (c) 2022 Elsevier Inc. All rights reserved. (Am J Cardiol 2022;182:1-7)

Automated summary

This study followed up patients treated with ABSORB-BVS for 5 years and found that while the absorbed scaffolds demonstrated complete structural healing, there were impaired vasomotor responses in the treated segments.