PERCUTANEOUS CORONARY INTERVENTION WITH BIORESORBABLE VASCULAR SCAFFOLD VERSUS MINIMALLY INVASIVE OFF-PUMP BYPASS SURGERY: 30-DAYS FOLLOW UP
https://doi.org/10.17802/2306-1278-2018-7-3-56-64
Abstract
Aim. To assess the comparative 30-day effectiveness of percutaneous coronary intervention (PCI) with bioresorbable vascular scaffold (BVS) versus minimally invasive direct coronary artery bypass (MIDCAB) for left anterior descending coronary artery disease.
Methods. 130 patients with significant (≥70%) LAD disease were recruited in the study. Patients were randomized either to PCI with BVS (n = 65) or MIDCAB (n = 65). The groups of patients were comparable in baseline demographic, clinical and angiographic parameters. The endpoints included adverse cardiovascular events (all-cause mortality, myocardial infarction, stroke, target vessel revascularization) and scaffold thrombosis and were measured on day 30 after the indexed intervention.
Results. At 30-day follow-up, there were no significant differences in the incidence of the adverse cardiovascular events between the study groups (0% MIDCAB vs. 3.1% PCI, р = 0.151), myocardial infarction (0% vs. 3.1%, p = 0.151), target vessel revascularization (0% vs. 1.5%, p = 0.32) and scaffold (graft) thrombosis (0% vs. 1.5%, p = 0.32).
Conclusion. PCI with BVS and MIDCAB in patients with stable coronary artery disease and isolated left anterior descending lesions demonstrated comparable outcomes at 30-days follow-up.
About the Authors
K. M. Vakkosov
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases».
Russian Federation
Russian Federation
Vakkosov Kamoliddin M., PhD student at the Department of Cardiology and Cardiovascular Surgery, research assistant, Laboratory of Interventional Cardiology.
6, Sosnoviy Blvd., Kemerovo, 650002.
V. I. Ganjukov
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases».
Russian Federation
Russian Federation
Ganyukov Vladimir I., PhD, Head of the Laboratory of Interventional Cardiology.
6, Sosnoviy Blvd., Kemerovo, 650002.
S. V. Ivanov
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases».
Russian Federation
Russian Federation
Ivanov Sergey V., PhD, leading researcher at the Laboratory of Reconstructive Surgery of Polyvascular and Multivessel Disease.
6, Sosnoviy Blvd., Kemerovo, 650002.
O. L. Barbarash
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases».
Russian Federation
Russian Federation
Barbarash Olga L., PhD, Professor, Corresponding member of the Russian Academy of Sciences, Director.
6, Sosnoviy Blvd., Kemerovo, 650002.
L. S. Barbarash
Federal State Budgetary Institution «Research Institute for Complex Issues of Cardiovascular Diseases».
Russian Federation
Russian Federation
Barbarash Leonid S., PhD, Professor, Academician of the Russian Academy of Sciences, Chief Researcher.
6, Sosnoviy Blvd., Kemerovo, 650002.
References
1. Mohr F., Redwood S., Venn G., Colombo A., Mack M., Kappetein P., et al. Coronary artery bypass graft surgery versus percutaneous coronary intervention in patients with threevessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. 2013. Lancet. Feb 23; 381(9867):629-38. doi: 10.1016/S0140-6736(13)60141-5.
2. Raja S., Benedetto U., Alkizwini E., Gupta S., Amrani M., Harefield Cardiac Outcomes Research Group Propensity Score Adjusted Comparison of MIDCAB Versus Full Sternotomy Left Anterior Descending Artery Revascularization. Innovations (Phila). 2015 May-Jun; 10(3):174-8. doi: 10.1097/IMI.0000000000000162.
3. Serruys P., de Jaegere P., Kiemeneij F., Macaya C., Rutsch W., Heyndrickx G. et al. A comparison of balloon-expandablestent implantation with balloon angioplasty in patients with coronary artery disease. Benestent Study Group. N Engl J Med. 1994; 331: 489-495. DOI: 10.1056/NEJM199408253310801
4. Räber L., Wohlwend L., Wigger M., Togni M., Wandel S., Wenaweser P. et al. Five-year clinical and angiographic outcomes of a randomized comparison of sirolimus-eluting and paclitaxel-eluting stents: results of the Sirolimus-Eluting Versus Paclitaxel-Eluting Stents for Coronary Revascularization LATE trial. Circulation. 2011 Jun 21;123 (24): 2819-28, 6 p following 2828. doi: 10.1161/CIRCULATIONAHA.110.004762.
5. Ellis S., Kereiakes D., Metzger D., Caputo R., Rizik D., Teirstein P., et al. ABSORB III Investigators. EverolimusEluting Bioresorbable Scaffolds for Coronary Artery Disease. N Engl J Med. 2015 Nov 12;373(20):1905-15. doi: 10.1056/NEJMoa1509038.
6. Blazek S., Holzhey D., Jungert C., Borger M.A., Fuernau G., Desch S. Comparison of bare-metal stenting with minimally invasive bypass surgery for stenosis of the left anterior descending coronary artery: 10-year follow-up of a randomized trial. J Am Coll Cardiol Intv. 2013; 6(1):20-6. doi: org/10.1016/j.jcin.2012.09.008
7. Benedetto U., Raja S.G., Soliman R.F., Albanese A., Jothidasan A., Ilsley C.D. at al. Minimally invasive direct coronary artery bypass improves late survival compared with drug-eluting stents in isolated proximal left anterior descending artery disease: a 10-year follow-up, single-center, propensity score analysis. J Thorac Cardiovasc Surg. 2014 Oct;148(4):1316-22. doi: 10.1016/j.jtcvs.2013.12.062. яС
8. Wang X., Qu C., Huang C., Xiang X., Lu Z. Minimally invasive direct coronary bypass compared with percutaneous coronary intervention for left anterior descending artery disease: a meta-analysis. J Cardiothorac Surg. 2016 Aug 5;11(1):125. doi: 10.1186/s13019-016-0512-1.
9. Tamburino C., Latib A., van Geuns R., Sabate M., Mehilli J., Gori T., et al. Contemporary practice and technical aspects in coronary intervention with bioresorbable scaffolds: a European perspective. EuroIntervention. 2015; 11: 45-52. doi: 10.4244/ EIJY15M01_05.
10. Capodanno D., Joner M., Zimarino M. What about the risk of thrombosis with bioresorbable scaffolds? EuroIntervention. 2015.
11. V181-V184. doi: 10.4244/EIJV11SVA43. 11. Lipinski M., Escarcega R., Baker N., Benn H., Gaglia M. Jr, Torquson R., et al. Scaffold thrombosis after percutaneous coronary intervention with Absorb Bioresorbable Vascular Scaffold: A systematic review and meta-analysis. JACC Cardiovasc Interv. 2016 Jan 11; 9 (1):12-24. doi: 10.1016/j. jcin.2015.09.024.
12. Planer D., Smits P., Kereiakes D., Kedhi E., Fahy M., Xu K., et al. Comparison of everolimus- and paclitaxel-eluting stents in patients with acute and stable coronary syndromes pooled results from the SPIRIT (A Clinical Evaluation of the XIENCE V Everolimus Eluting Coronary Stent System) and COMPARE (A Trial of Everolimus-Eluting Stents and Paclitaxel-Eluting Stents for Coronary Revascularization in Daily Practice) trials. JACC Cardiovasc Interv. 2011 Oct; 4 (10):1104-15. doi: 10.1016/j.jcin.2011.06.018.
13. Machado C., Raposo L., Dores H., Leal S., Campante Teles R., de Araújo Gonçalves P., et al. Second-generation versus first-generation drug-eluting stents for the treatment of patients with acute coronary syndromes and obstructive coronary artery disease. Coron Artery Dis. 2014 May; 25(3):208-14. doi: 10.1097/MCA.0000000000000078.
14. Head S., Börgermann J., Osnabrugge J., Kieser M., Falk V., Taggart P., et al. Coronary artery bypass grafting: part 2 — optimizing outcomes and future prospects, Eur. Heart J. 34 (2013) 2873–2886. DOI: 10.1093/eurheartj/eht284.
15. King C., Reece B., Hurst L., Shockey S., Tribble G., Spotniz D., et al., Minimally invasive coronary artery bypass grafting decreases hospital stay and cost, Ann. Surg. 225 (1997) 805–809.
16. Dogan S., Dzemali O., Wimmer-Greinecker G., Derra P., Doss M., Khan F., et al., Minimally invasive versus conventional aortic valve replacement: a prospective randomized trial, J. Heart Valve Dis. 12 (2003) 76–80.
17. Birla R., Patel P., Aresu G., Asimakopoulos G. Minimally invasive direct coronary artery bypass versus offpump coronary surgery through sternotomy. Ann R Coll Surg Engl. 2013 Oct; 95(7):481-5. doi: 10.1308/003588413X13629960047119.
18. Deppe C., Liakopoulos J., Kuhn W., Slottosch I., Scherner M., Choi H., et al. Minimally invasive direct coronary bypass grafting versus percutaneous coronary intervention for single-vessel disease: a meta-analysis of 2885 patients. Eur J Cardiothorac Surg. 2015 Mar; 47(3):397-406; discussion 406. doi: 10.1093/ejcts/ezu285.
19. Dieberg G., Smart A., King N. Minimally invasive cardiac surgery: A systematic review and meta-analysis. Int J Cardiol. 2016 Nov 15; 223:554-560. doi: 10.1016/j.ijcard.2016.08.227.
20. Birla R., Patel P., Aresu G., Asimakopoulos G. Minimally invasive direct coronary artery bypass versus off-pump coronary surgery through sternotomy Ann R Coll Surg Engl 2013; 95: 481–485 doi: 10.1308/003588413X13629960047119.
Review
For citations:
Vakkosov K.M., Ganjukov V.I., Ivanov S.V., Barbarash O.L., Barbarash L.S. PERCUTANEOUS CORONARY INTERVENTION WITH BIORESORBABLE VASCULAR SCAFFOLD VERSUS MINIMALLY INVASIVE OFF-PUMP BYPASS SURGERY: 30-DAYS FOLLOW UP. Complex Issues of Cardiovascular Diseases. 2018;7(3):56-64. (In Russ.) https://doi.org/10.17802/2306-1278-2018-7-3-56-64
Views:
616
