Three‐year clinical outcomes of patients treated with everolimus‐eluting bioresorbable vascular scaffolds: Final results of the ABSORB EXTEND trial

• Published in: Catheterization and cardiovascular interventions 2019-01, Vol.93 (1), p.E1-E7
• Main Authors: Costa, J. Ribamar, Abizaid, Alexandre, Whitbourn, Robert, Serruys, Patrick W., Jepson, Nigel, Steinwender, Clemens, Stuteville, Marrianne, Ediebah, Divine, Sudhir, Krishnankutty, Bartorelli, Antonio L.
• Format: Article
• Language: English
• Subjects: Absorbable Implants; Aged; bioresorbable scaffold; Cardiovascular Agents - administration & dosage; Cardiovascular Agents - adverse effects; Clinical outcomes; Coated Materials, Biocompatible; Coronary Artery Disease - diagnostic imaging; Coronary Artery Disease - mortality; Coronary Artery Disease - therapy; Coronary Thrombosis - epidemiology; Diabetes mellitus; everolimus; Everolimus - administration & dosage; Everolimus - adverse effects; Female; Humans; Implants; Ischemia; Lesions; Male; Middle Aged; Patients; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - instrumentation; Percutaneous Coronary Intervention - mortality; Prospective Studies; Prosthesis Design; Risk Assessment; Risk Factors; Thromboembolism; Thrombosis; Time Factors; Treatment Outcome
• ISSN: 1522-1946; 1522-726X
• DOI: 10.1002/ccd.27715

Background There is still limited data on the very long term clinical outcomes after ABSORB BRS in daily practice. We sought to evaluate the 3 year‐performance of the Absorb bioresorbable vascular scaffolds for the treatment of low/moderate complexity patients enrolled in the ABSORB EXTEND trial. Methods ABSORB EXTEND is a prospective, single‐arm, open‐label clinical study in which 812 patients were enrolled at 56 sites. This study allowed the treatment of lesions ≤28 mm in length and reference vessel diameter of 2.0–3.8 mm (as assessed by on‐line QCA). To determine the independent predictors of MACE, a multivariable logistic regression model was built using a stepwise (forward/backward) procedure. Results Average population age was 61 years and 26.5% had diabetes. Most patients had single target lesion (92.4%). Adequate scaffold deployment (PSP) was achieved in 14.2% of the cases. At three years, the composite endpoints of MACE and ischemia‐driven target vessel failure were 9.2% and 10.6%, respectively. The cumulative rate of ARC definite/probable thrombosis was 2.2%, with 1.2% of the cases occurring after the 1st year. Independent predictors of MACE were hypertension and the need for “bail out” stent. Conclusion At three‐year follow‐up, the use of ABSORB in low/moderate complex PCI was associated with low and acceptable rates of major adverse clinical events, despite the infrequent use of the recommended contemporary scaffold deployment technique. However, scaffold thrombosis rate was higher than reported with current generation of metallic DES. The study is registered on clinicaltrials.gov (unique identifier NCT01023789).