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Assessment of the serial changes of necrotic core and calcium content in atherosclerotic coronary lesion with bioresorbable everolimus-eluting vascular scaffolds using Shin’s method: An IVUS study
울산대학교병원¹ , Erasmus MC²
신은석¹, Hector M. Garcia-Garcia² , Scot Garg², Leif Thuesen³, Dariusz Dudek⁴, John A.Ormiston5, Patrick W. Serruys²
Background: Although serial changes in necrotic core and calcium are regarded as surrogates for the bioresorption process in patients treated with the bioresorbable everolimus-eluting vascular scaffolds (BVS), these temporal changes have not yet been fully investigated. Shin’s method may be offer a more suitable technique for this analysis because it includes all the contents of both the lumen and vessel wall. Objective: The purpose of this study was to assess the serial changes of necrotic core and dense calcium content in coronary lesions that were treated with a BVS implant using Virtual Histology-intravascular ultrasound (VH-IVUS) analyzed using Shin’s method. Methods: A total of 29 patients (92 coronary segments) were imaged to evaluate the serial changes in necrotic core and dense calcium using Shin’s method. Lesions treated with a BVS implant were analyzed with serial VH-IVUS assessments, i.e., pre- and post-stenting, and at 6 months and 2 years follow-up. In Shin’s method contours are drawn around the IVUS catheter (instead of delineating the lumen) and the vessel. Results The mean necrotic core area decreased by 6.9% from post-stenting to 6 months (1.71 ± 1.03 mm² vs. 1.36 ± 0.91 mm², p = 0.027), and by 20.5% (1.71 ± 1.03 mm² vs. 1.20 ± 0.70 mm², p = 0.003) from post-steting to 2 years; while the mean dense calcium areas decreased by 27.2% (1.07 ± 0.55 mm² vs. 0.78 ± 0.64 mm², p = 0.039) from post-stenting and 2 years. Conclusions: At 2 years, absolute necrotic core and dense calcium content were significantly decreased as compared to post-stenting values. The present study demonstrates that the bioresorption process in patients who undergoing BVS device implantation can be assessed using VH-IVUS analysed using Shin’s method.


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