Home > Journals > Minerva Cardioangiologica > Past Issues > Minerva Cardioangiologica 2016 August;64(4) > Minerva Cardioangiologica 2016 August;64(4):487-93

CURRENT ISSUE
 

ARTICLE TOOLS

Reprints

MINERVA CARDIOANGIOLOGICA

A Journal on Heart and Vascular Diseases


Official Journal of the Italian Society of Angiology and Vascular Pathology
Indexed/Abstracted in: EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,752


eTOC

 

REVIEWS  NEW BIORESORBABLE TECHNOLOGY IN INTERVENTIONAL CARDIOLOGY


Minerva Cardioangiologica 2016 August;64(4):487-93

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Cardiac allograft vasculopathy: optical coherence guided innovative treatment options with the bioresorbable vascular scaffold: proof of concept

István F. ÉDES, Ágota HAJAS, Balázs SAX, Andrea BARTYKOWSZKI, Dávid BECKER, Béla MERKELY

Semmelweis University, Heart and Vascular Center, Budapest, Hungary


PDF  


The aim of our work was to assess a novel interventional therapy option in cardiac allograft vasculopathy (CAV), a complex form of coronary disease presenting only in heart transplant (HTx) recipients. It is typically a rapidly progressing phenomenon, affecting the entire coronary circulation causing diffuse, severe coronary lesions and has no one unique cause. Treatment options are limited, but where eligible, palliation via percutaneous revascularization (PCI) mainly using new generation drug eluting stents (DES) is recommended. Our working group sought to assess outcomes of CAV PCI using an Absorb (Abbott Vascular, Santa Clara, CA, USA) fully bioresorbable, everolimus eluting vascular scaffold (BVS), under optical coherence tomography (OCT) guidance. Our initial, proof-of-concept case showed a late CAV, macrophage and foam-cell rich lesion, with typical asymmetric intimal hyperplasia and contralateral thin-cap fibroatheroma formation. Post-PCI OCT showed underexpansion, requiring aggressive postdilatation. Ninety-day follow-up CT angiogram identified the scaffold and displayed a patent lumen of the device. BVS use thus seems eligible in CAV, yet needs proper, meticulous implantation. Use may also delay CAV progression as lesion healing is promoted, with restoration of vasomotion and a natural increase in vascular lumen. Furthermore, the chronically present vascular irritation surrounding stent/scaffold struts may subside, as no permanent metal is present as an increased substrate for inflammation. To assess full efficacy, further studies will be needed.

top of page

Publication History

Cite this article as

Corresponding author e-mail

edes789@gmail.com