# Bioresorbeerbare scaffold-trombose: multicenteranalyse van klinische presentatie en mechanismen

*geplaatst 2016-03-01 · Algemeen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2015.12.019 · https://hartvaat.nl/2016/03/01/bioresorbeerbare-scaffold-trombose-multicenteranalyse-van-klinische-presentatie-/*

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.

## English: Bioresorbable Coronary Scaffold Thrombosis: Multicenter Comprehensive Analysis of Clinical Presentation, Mechanisms, and Predictors.

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.

## Abstract (original, from the publication)

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).

Auteurs: Serban Puricel, Florim Cuculi, Melissa Weissner, Axel Schmermund, Peiman Jamshidi, Tobias Nyffenegger, Harald Binder, Holger Eggebrecht, Thomas Münzel, Stephane Cook, Tommaso Gori

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2015.12.019. Bijgewerkt 2026-07-03T13:25:20Z. 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.