N. P. Strygo, V. I. Stelmashok, O. L. Polonetsky
Aim. To establish efficacy and safety of endovascular correction of long coronary lesion with biodegradable scaffolds in comparison with everolimus-eluting metallic coronary stents. Materials and methods. From 2013 to 2018 in Republican Scientific and Practical Centre «Cardiology», Minsk, endovascular correction of long (more than 25 mm) coronary artery lesions was performed on 80 patients. Randomly patients were divided into 2 groups: group 1 (n = 40) – endovascular correction with the biodegradable everolimus-eluting vascular scaffold Absorb BVS, and group 2 (n = 40) – endovascular correction with the everolimus-eluting metallic stent Xience V/Xience Pro. Results. In 12-month observational period there were no cases of death or myocardial infarction in both groups. One-year primary endpoint (death + myocardial infarction + target lesion failure) was 10% in group 1 (scaffolds BVS Absorb) and 8.75% in group 2 (Xience stents), 4 and 3 cases of target lesion failure accordingly (p > 0.05). As secondary endpoints there were 3 cases of target lesion revascularization registered and 4 cases of target vessel revascularization in each group, 5 cases of target vessel failure in group 1 and 4 cases in group 2 (p > 0.05). There was 1 case of confirmed and 1 case of probable scaffold thrombosis in group 1 (cumulative rate 5%), no cases of stent thrombosis in group 2 (p = 0.49). Conclusion. Long lesion correction with biodegradable scaffolds shows similar one-year clinical and angiographic results in comparison with everolimus-eluting stents. Combined endpoint risk (all death cases + myocardial infarction + revascularization due to target lesion failure) statistically did not differ in one-year period in both groups.
keywords: ischemic heart disease, coronary artery, coronary stent, biodegradable vascular scaffold, coronary angioplasty, long coronary lesion, optical coherence tomography, intravascular ultrasound

for references: N. P. Strygo, V. I. Stelmashok, O. L. Polonetsky. Medium-term outcomes after correction of long coronary artery lesions with biodegradable vascular scaffolds. Neotlozhnaya kardiologiya i kardioovaskulyarnye riski [Emergency cardiology and cardiovascular risks], 2020, vol. 4, no. 2, pp. 1013–1018

1. Belarus’ v cifrah: stat. sprav [Belarus in numbers] / Nac. stat. komitet Resp. Belarus’. Minsk, 2017, pp. 1-72. (in Russian).
2. StrygoN.P. Rentgenoanatomicheskie osobennosti protyazhennyh porazhenij koronarnyh arterij[X-ray Anatomical Features of Long Lesions of Coronary Arteries]. Kardiologiya v Belarusi, 2019, vol. 11, no. 2, pp. 265-272. (in Russian).
3. Kastrati A., Elezi S., Dirschinger J., Hadamitzky M., Neumann F.J., Schomig A. Inf luence of lesion length on restenosis af ter coronar y stent placement. Am J Cardiol,1999, vol. 83, no. 12, pp. 1617-1622.
4. Kobayashi Y., De Gregorio J., Kobayashi N., Akiyama T., Reimers B., Finci L., Di Mario C., Colombo A. Stented segment length as an independent predictor of restenosis. J AmColf Cardiol, 1999,vol. 34,no. 3, pp. 651-659.
5. Suh J., Park D.W., Lee J.Y., Jung I.H., Lee S.W., Kim Y.H., Lee C.W., Cheong S.S., Kim J.J., Park S.W., Park S.J. The relationship and threshold of stent length with regard to risk of stent thrombosis after drug-eluting stent implantation. JACC Cardiovasc. Interv., 2010, vol. 3, no. 4, pp. 383-389.
6. Stel’mashok V.I. Vnutristentovoe restenozirovanie v srednesrochnom periode posle uspeshno vy’polnennoy rekanalizacii hronicheskih okklyuziy koronarny’h arteriy antegradny’m dostupom [Intra-stent restenosis in the medium term after successful recanalization of chronic coronary artery occlusions with antegrade access].Vesci NAN Belarusi. Ser med navuk, 2019, vol. 16, no. 1, pp. 65-76. (in Russian).
7. Ormiston J., SerruysP. Bioabsorbable coronary stents.Circ Cardiovasc Interv, 2009, vol. 2,no. 3, pp. 255-260.
8. Ormiston J.A., Serruys P.W., Regar E., Dudek D., Thuesen L.,Webster M.W.I., Onuma Y., Garcia-Garcia H.M., McGreevy R., Veldhof S. A bioabsorbable everolimus-eluting coronary stent system for patients with single de-novo coronary artery lesions (ABSORB): a prospective open-label trial. Lancet, 2008, vol. 371, no. 9616, pp. 899-907.
9. Ghimire G., Spiro J., Kharbanda R., Roughton M., Barlis P., Mason M., Ilsley C., Di Mario C., Erbel R., Waksman R., Dalby M. Initial evidence for the return of coronary vasoreactivity following the absorption of bioabsorbable magnesium alloy coronary stents. EuroIntervention, 2009, vol. 4, no. 4, pp. 481-484.
10. Onuma Y., Serruys P.W. Bioresorbable scaffold: the advent of a new era in percutaneous coronary and peripheral revascularization? Circulation, 2011, vol. 123, no. 7, pp. 779-797.
11. Dudek D., Onuma Y., Ormiston J. A., Thuesen L., Miquel-Hebert K., Serruys P. Four-year clinical follow-up of the ABSORB everolimus-eluting bioresorbable vascular scaffold in patients with de novo coronary artery disease: The ABSORB trial. Eurointervention, 2012, vol. 7, no. 9, pp. 1060-1061.
12. Serruys P., Ormiston J., van Geuns R.J., de Bruyne B., Dudek D., Christiansen E., Chevalier B., Smits P., Mcclean D., Koolen J., Windecker S., Whitbourn R., Meredith I., Wasungu L., Ediebah D.E., Veldhof S., Onuma Y.A Polylactide Bioresorbable Scaffold Eluting Everolimus for Treatment of Coronary Stenosis: 5-Year Follow-Up.J Am Coll Cardiol, 2016,vol. 67,no. 7, pp. 766-776.
13. Chevalier B., Onuma Y., van Boven A.J., Piek J.J., Sabaté M., Helqvist S., Baumbach A., Smits P.C., Kumar R., Wasungu L., Serruys P.W. Randomised comparison of a bioresorbable everolimus-eluting scaffold with a metallic everolimus-eluting stent for ischaemic heart disease caused by de novo native coronary artery lesions: the 2-year clinical outcomes of the ABSORB II trial. EuroIntervention, 2016, vol. 12, no. 9, pp. 1102-1107.
14. Ellis S.G., Kereiakes D.J., Metzger D.C., Caputo R.P., Rizik D.G., Teirstein P.S., Litt M.R., Kini A., Kabour A., Marx S.O., Popma J.J., McGreevy R., Zhang Z., Simonton C., Stone G.W. Everolimus-Eluting Bioresorbable Scaffolds for Coronary Artery Disease. N Engl J Med, 2015,vol. 373, no. 20, pp. 1905-1915.
15. Kereiakes D.J., Ellis S.G., Metzger C., Caputo R.P., Rizik D.G., Teirstein P.S., Litt, M.R., Kini A., Kabour A., Marx S.O., Popma J.J., McGreevy R., Zhang Z., Simonton C., Stone G.W. 3-Year Clinical Outcomes With Everolimus-Eluting Bioresorbable Coronary Scaffolds: The ABSORB III Trial. J Am Coll Cardiol, 2017, vol. 70, no. 23 pp. 2852-2862.
16. Strygo N.P., Polonetsky O.L., Stelmashok V.I. Osobennosti primeneniya biodegradiruemyh sosudistyh skaffoldov u pacientov s protyazhennymi porazheniyami koronarnyh arterij. [Special aspects of biodegradable vascular scaffolds usage in patients with long coronary artery lesions]. Kardiologiya v Belarusi, 2014, vol. 35, no. 4, pp. 25-35. (in Russian).
17. MrochekA.G., Stel’mashokV.I., StrigoN.P., PoloneckijO.L., ZacepinA.O., ZaharevichA.N., Bel’skijE.V. Sposob implantacii biodegradiruemogo sosudistogo skaffolda posle rekanalizacii hronicheskoj protyazhennoj okklyuzii koronarnoj arterii[Method of im-plantation of a biodegradable vascular scaffold after recanalization of chronic extended coronary artery occlusion]. Patent BY 21809, 2018. (in Russian).
18. Gao R., Yang Y., Han Y., Huo Y., Chen J., Yu B., Su X., Li L., Kuo H.C., Ying S.W., Cheong W.F., Zhang Y., Su, X., Xu B., Popma J.J., Stone G.W. Bioresorbable Vascular Scaffolds Versus Metallic Stents in Patients With Coronary Artery Disease: ABSORB China Trial. J Am Coll Cardiol,2015,vol. 66, no. 21, pp. 2298-2309.
19. Onuma Y., Sotomi Y., Shiomi H., Ozaki Y., Namiki A., Yasuda S., Ueno T., Ando K., Furuya J., Igarashi K., Kozuma K., Tanabe K., Kusano H., Rapoza R., Popma J.J., Stone G.W., Simonton C., Serruys P.W., Kimura T. Two-year clinical, angiographic, and serial optical coherence tomographic follow-up after implantation of an everolimus-eluting bioresorbable scaffold and an everolimus-eluting metallic stent: insights from the randomised ABSORB Japan trial. EuroIntervention, 2016,vol. 12, no. 9, pp. 1090-1101.
20. Cassese S., Byrne R.A., Ndrepepa G., Kufner S., Wiebe J., Repp J., Schunkert H., Fusaro M., Kimura T., Kastrati A. Everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting metallic stents: a meta-analysis of randomised controlled trials. Lancet,2016,vol. 387, no. 10018pp. 537-544.
21. Xu B., Yang Y., Han Y., Huo Y., Wang L., Qi X., Li J., Chen Y., Kuo H.C., Ying S.W., Cheong W.F., Zhang Y., Su X., Popma J.J., Gao R., Stone G.W. Comparison of everolimus-eluting bioresorbable vascular scaffolds and metallic stents: three-year clinical outcomes from the ABSORB China randomised trial. EuroIntervention, 2018, vol. 14, no. 5, pp. 554-561.
22. Kozuma K., Tanabe K., Kimura T.ABSORB-Japan: 3-year clinical and angiographic results of a randomized trial evaluating the Absorb bioresorbable vascular scaffold vs metallic. Drug-eluting Stent in de novo Native Coronary Artery Lesions [Electronic resource]: Available at: https://www.tctmd.com/slide/absorb-japan-results-3-year-clinical-and-angiographic-results.(access 29.11.2017).
23. Baumbach A., Zaman A., West N., O’Kane P., Egred M., Johnson T., Wheatcroft S., Bowles R., de Belder A., Bouras G., Lansky A., Hill J., Mathur A., de Belder M.A., Banning A.P. Acute and one-year clinical outcomes following implantation of bioresorbable vascular scaffolds: the ABSORB UK Registry. EuroIntervention, 2018, vol. 13, no. 13, pp. 1554-1560.
24. Geraci S., Kawamoto H., Capodanno D., Caramanno G., Latib A.. Bioresorbable Everolimus-Eluting Vascular Scaffold for Long Coronary Lesions: A Subanalysis of the International, Multicenter GHOST-EU (Gauging coronary Healing with bioresorbable Scaffolding plaTforms in EUrope) Registry. JACC Cardiovasc Interv, 2017, vol. 10, no. 12, pp.1274-1275.
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