Everolimus-eluting Bioresorbable Vascular Scaffolds Implanted in Coronary Bifurcation Lesions

Background Limited data are available on bioresorbable vascular scaffolds (BVS) performance in bifurcations lesions and on the impact of BVS wider struts on side-branch impairment. Methods Patients with at least one coronary bifurcation lesion involving a side-branch ≥2 mm in diameter and treated with at least one BVS were examined. Procedural and angiographic data were collected and a dedicated methodology for off-line quantitative coronary angiography (QCA) in bifurcation was applied (eleven-segment model), to assess side-branch impairment occurring any time during the procedure. Two- and three-dimensional QCA were used. Optical coherence tomography (OCT) analysis was performed in a subgroup of patients and long-term clinical outcomes reported. Results A total of 102 patients with 107 lesions, were evaluated. Device- and procedural-successes were 99.1% and 94.3%, respectively. Side-branch impairment occurring any time during the procedure was reported in 13 bifurcations (12.1%) and at the end of the procedure in 6.5%. Side-branch minimal lumen diameter (Pre: 1.45 ± 0.41 mm vs Final: 1.48 ± 0.42 mm, p = 0.587) %diameter-stenosis (Pre: 26.93 ± 16.89% vs Final: 27.80 ± 15.57%, p = 0.904) and minimal lumen area (Pre: 1.97 ± 0.89 mm2 vs Final: 2.17 ± 1.09 mm2, p = 0.334), were not significantly affected by BVS implantation. Mean malapposed struts at the bifurcation polygon-of-confluence were 0.63 ± 1.11. Conclusions The results of the present investigation suggest feasibility and relative safety of BVS implantation in coronary bifurcations. BVS wide struts have a low impact on side-branch impairment when considering bifurcations with side-branch diameter ≥ 2 mm.