{"id":"7f3c80ef2e27","type":"article","url":"https://hartvaat.nl/2016/03/01/bioresorbeerbare-scaffold-trombose-multicenteranalyse-van-klinische-presentatie-/","title":"Bioresorbeerbare scaffold-trombose: multicenteranalyse van klinische presentatie en mechanismen","title_en":"Bioresorbable Coronary Scaffold Thrombosis: Multicenter Comprehensive Analysis of Clinical Presentation, Mechanisms, and Predictors.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["klepprothese"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2015.12.019","source_url":"https://doi.org/10.1016/j.jacc.2015.12.019","authors":["Serban Puricel","Florim Cuculi","Melissa Weissner","Axel Schmermund","Peiman Jamshidi","Tobias Nyffenegger","Harald Binder","Holger Eggebrecht","Thomas Münzel","Stephane Cook","Tommaso Gori"],"significance":7,"published":"2016-03-01","source_date":"2016-03-01","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/ischemie-reperfusieschade/"],"congress":"","summary_en":"This multicenter analysis characterized the incidence, mechanisms, and predictors of bioresorbable vascular scaffold thrombosis, identifying key risk factors that contributed to the eventual withdrawal of first-generation bioresorbable devices.","created":"2026-07-03T10:25:58Z","updated":"2026-07-03T13:25:20Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Multicenter analyse die de incidentie, klinische presentatie, mechanismen en voorspellers van bioresorbeerbare vasculaire scaffold-trombose onderzocht. Wijst op een mogelijk verhoogd tromboserisico vergeleken met metallic stents.","abstract_original":"BACKGROUND: Recent reports suggest an elevated incidence of bioresorbable vascular scaffold (BVS) thrombosis (scaffold thrombosis [ScT]). OBJECTIVES: This study investigated occurrence rates, clinical and angiographic characteristics, and possible mechanisms of ScT in all-comer patients undergoing BVS implantation at 2 German and 2 Swiss hospitals. METHODS: A total of 1,305 consecutive patients (mean age 64 years, 78% male) who received 1,870 BVS (mean 1.4 ± 0.8 BVS/patient) were enrolled. Clinical/procedural characteristics, mortality, and ScT data at 485 days (range 312 to 652 days) were examined. RESULTS: ScT occurred in 42 patients. The incidence of probable and definite ScT was 1.8% at 30 days and 3.0% at 12 months, without differences among centers (p = 0.60). A total of 22 (52%) ScTs presented as ST-segment elevation myocardial infarction and 6 (17%) as sudden cardiac death. In multivariable analysis, ostial lesions (p = 0.049) and impaired left ventricular ejection fraction (p = 0.019) were independently associated with ScT. Nine (21%) of the ScTs occurred in patients who had suspended dual antiplatelet therapy, in 6 cases prematurely. Lower post-procedural minimum lumen and reference vessel diameters were hallmarks of ScT (all p < 0.0001). The risk of ScT appeared to rapidly increase for post-procedural minimum lumen diameters below 2.4 mm (for the 2.5- to 3.0-mm BVS) and 2.8 mm (for the 3.5-mm BVS). When a BVS-specific implantation strategy was implemented, 12-month ScT rates fell from 3.3% to 1.0%, an effect that remained significant when adjusted for multivariable propensity score (p = 0.012; hazard ratio: 0.19; 95% confidence interval: 0.05 to 0.70). CONCLUSIONS: The 12-month incidence of ScT reached 3% and could be significantly reduced when an optimized implantation strategy was employed. (retrospective multicentric registry and Mainz Intracoronary Database. The Coronary Slow-flow and Microvascular Diseases Registry [MICAT]; NCT02180178)."}