Spatial Distribution and Temporal Evolution of Scattering Centers by Optical Coherence Tomography in the Poly(L-Lactide) Backbone of a Bioresorbable Vascular Scaffold

• Published in: Circulation Journal 2012, Vol.76(2), pp.342-350
• Main Authors: Gutiérrez-Chico, Juan Luis, Radu, Maria D., Diletti, Roberto, Sheehy, Alexander, Kossuth, Mary Beth, Oberhauser, James P., Glauser, Thierry, Harrington, Joel, Rapoza, Richard J., Onuma, Yoshinobu, Serruys, Patrick W.
• Format: Article
• Language: English
• Subjects: Absorbable Implants; Angioplasty, Balloon, Coronary; Cardiac Imaging Techniques - methods; Cohort Studies; Coronary Artery Disease - diagnosis; Coronary Artery Disease - therapy; Coronary stenosis; Drug-Eluting Stents; Everolimus; Follow-Up Studies; Humans; Hydrolysis; Immunosuppressive Agents - therapeutic use; Optical coherence; Poly(lactide); Polyesters; Prosthesis Design; Registries; Sirolimus - analogs & derivatives; Sirolimus - therapeutic use; Tomography; Tomography, Optical Coherence - methods
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-11-0726

Background: Scattering centers (SC) are often observed with optical coherence tomography (OCT) in some struts of bioresorbable vascular scaffolds (BVS). These SC might be caused by crazes in the polymer during crimp-deployment (more frequent at inflection points) or by other processes, such as physiological loading or hydrolysis (eventually increasing with time). The spatial distribution and temporal evolution of SC in BVS might help to understand their meaning. Methods and Results: Three patients were randomly selected from 12 imaged with Fourier-domain OCT at both baseline and 6 months in the ABSORB cohort B study (NCT00856856). Frame-by-frame analysis of the SC distribution was performed using spread-out vessel charts, and the results from baseline and 6 months were compared. A total of 4,328 struts were analyzed. At baseline and follow-up all SC appeared at inflection points. No significant difference was observed between baseline and 6 months in the number of SC struts (14.9 vs. 14.5%, P=0.754) or in the distribution of SC. The proportion and distribution of SC did not vary substantially among the patients analyzed. Conclusions: The SC observed in OCT imaging of the BVS are located exclusively at inflection points and do not increase with time. These findings strongly suggest that SC are caused by crazes in the polymer during crimp-deployment, ruling out any major role of hydrolysis or other time-dependent processes. (Circ J 2012; 76: 342-350)