Background:
Direct stenting is an effective technique for treating significant coronary artery lesions in select cases. However, plaque preparation has been strongly endorsed prior to the deployment of ABSORBTM, an everolimus-eluting bioresorbable vascular scaffold (BVS) due to its different mechanical properties.
Purpose:
We assessed the feasibility and safety of direct BVS deployment without plaque modification in de novo coronary artery lesions.
Methodology:
We reviewed all cases of direct BVS deployment since its introduction to our center in June 2013. Data was obtained for demography, procedural characteristics, in-hospital and 30-day survival.
Results:
Nine patients successfully received eleven BVS using direct stenting for the treatment of significant coronary artery lesions. Mean age was 55.6+3.1 years, and 44% of patients were females. Nearly half of the patients had hypertension, diabetes, and were actively smoking at the time of presentation. All patients presented with acute coronary syndrome. Most of the patients presented with STEMI (89%), and 67% received primary PCI.
The mean Syntax score was 8.4+1.6, with 64% being type “C” ACC lesions and 55% containing predominantly thrombus. All lesions were treated with successful deployment of BVS in first attempt.
Post stenting, TIMI-3 flow was achieved in 91% (10/11) of lesions. There was no case of worsening coronary TIMI flow post-BVS deployment. In 44% of cases, the scaffold was applied across bifurcation lesions without an accompanying loss of coronary flow to the side branches.
Conclusion:
Direct deployment of BVS without lesion modification, in selected patients, is a safe and viable choice. Larger randomized trials are needed.
