Coronary evaginations and peri-scaffold XXXX following implantation of bioresorbable scaffolds: incidence, outcome, and optical coherence tomography analysis of possible mechanisms.

@entity1 @entity174 @entity6 @entity439 @entity715
BACKGROUND: Peri-stent coronary evaginations may disturb flow and have been proposed as possible risk factor for late stent @entity715 . We describe incidence, predictors, and possible mechanisms of coronary evaginations 12 months after implantation of bioresorbable vascular scaffolds (BVS). METHODS AND RESULTS: One hundred and two BVS implanted in 90 @entity1 (age 63    13 years, 71 males, 14 @entity6 ) were analysed with angiography and optical coherence tomography (OCT) 12 months after implantation. Evaginations were identified as any hollow in the luminal vessel contour between well-apposed struts and were classified as major when extending >= 3 mm with a depth >= 10% of the BVS diameter. Fifty-five (54%) of the BVS (50(56%) of the @entity1 ) had at least one evagination (6.1    6.2 evaginations per BVS), with a mean volume of 1.9    1.9 mm(3). Major evaginations were only found in one @entity1 , and in-BVS @entity439 in three @entity1 (4BVS). The presence of evaginations was strongly associated with that of malapposition (P = 0.003) and strut @entity174 (P = 0.01). No association could be shown between the presence and volume of the evaginations and any clinical variable or the presence of uncovered struts (P > 0.5). Peri-strut low-intensity areas (PSLIA) were present in 29 (53%) of the BVS with evaginations and 12 (26%) of those without (P = 0.0049); their presence was independently associated with the presence, the number (P < 0.003) and volume of the evaginations (P = 0.004) and with that of strut @entity174 . CONCLUSIONS: Optical coherence tomography-detected evaginations are relatively common after BVS implantation, but, as for modern drug-eluting metallic stents, major evaginations are very rare. Optical coherence tomography evidence of immature neointima and strut @entity174 were associated with more severe development of evaginations.
