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Changes in coronary angulation after bioresorbable vascular scaffold and cobalt-chromium and stainless steel stent implantation

BACKGROUND: The conformability of the stent, defined as the adaptation of the prosthesis to the natural shape of the vessel, is the major cause of geometrical changes after stenting and is influenced by the stent material and design. It may be assessed by measuring changes in the curvature and the angulation of the treated segment after stent implantation. The objective of this study was to compare changes in coronary angulation after implantation of the bioresorbable vascular scaffold (BVS) and cobalt-chromium and stainless steel metal platforms used in second-generation drug-eluting stents. METHODS: In this retrospective analysis, 50 patients with single de novo lesions in native coronary arteries and diameter between 2.5 and 3.5 mm and length up to 23 mm were included. Twenty-five patients were treated with BVS and 25 patients were treated with cobalt-chromium (n = 12) or stainless steel (n = 13) platforms. Angulation was measured using a dedicated quantitative angiography analysis software. RESULTS: Vessel angulation significantly changed after device implantation. In the group submitted to the implantation of metal platforms there was greater coronary angulation change when compared to the group treated with BVS (41.6% vs. 14.9%; P < 0.01). When we analyzed the performance of the BVS and the different metal platforms, coronary angulation change was greater for the stainless steel platforms, followed by cobalt-chromium platforms and the BVS (53.7% vs. 28.5% vs. 14.9%; P < 0.01). CONCLUSIONS: In this preliminary assessment, the BVS produced a smaller coronary angulation change. The clinical impact of this finding must be prospectively investigated in a larger and more complex cohort.

Coronary vessels; Stents; Absorbable implants


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