The effect of elective implantation of the ABSORB bioresorbable vascular scaffold on coronary microcirculation: Serial assessment using the index of microcirculatory resistance. (9th January 2019) - Rampat, Rajiv
Abstract: Introduction: Stenting with metal stents can affect microcirculatory function. The impact of BVS on the microvascular network has not been studied. Methods: A total of 30 patients with bifurcation disease of Medina (X, X, 0) scheduled for elective PCI with the ABSORB BVS were studied. Pressure wire studies were performed before and after scaffold implantation and at a mean follow‐up of 9 months. At each time point, FFR, IMR, and CFR were calculated using the thermodilution method. Results: Following scaffold implantation, FFR change from pre‐PCI, post‐PCI and follow‐up was 0.76, 0.92 and 0.91, respectively ( P < 0.001 from pre to post‐PCI and P = 0.91 from post‐PCI to follow‐up). There was a statistically significant improvement between pre‐ and post‐procedural IMR (median 27.7 to 17.9, P = 0.02) and CFR (median 2.2 to 2.9, P = 0.02). Median IMR at follow‐up (23.6) remained numerically lower than pre‐procedure but this was not statistically significant ( P = 0.05). Similarly, while median CFR at follow‐up remained at post‐procedural level (2.9), this effect did not reach statistical significance ( P = 0.06). Conclusion: There is an immediate reduction in microvascular resistance after elective BVS implantation but this effect is not sustained long term.