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J Endovasc Ther ; 27(4): 616-622, 2020 Aug.
Article in English | MEDLINE | ID: mdl-32469296

ABSTRACT

Purpose: To report an experience with the Absorb bioresorbable vascular scaffold (BVS) in an Asian cohort with chronic limb-threatening ischemia (CLTI) from the DISAPEAR (Drug Impregnated Bioresorbable Stent in Asian Population Extremity Arterial Revascularization) registry. Materials and Methods: A retrospective analysis was conducted of 41 patients (median age 64 years; 23 men) with CLTI owing to >50% de novo infrapopliteal lesions (n=53) treated with the Absorb BVS between August 2012 and June 2017. The majority of patients (37, 90%) had diabetes, 24 (59%) had ischemic heart disease, and 39 (95%) had Rutherford category 5/6 ischemia with tissue loss. The mean lesion length was 22.7±17.2 mm; 10 (24%) lesions were severely calcified. Assessments included technical success, primary patency, freedom from clinically-driven target lesion revascularization (CD-TLR), amputation-free survival, limb salvage, complete wound healing, resolution of rest pain, and resolution of CLTI without TLR at 6 and 12 months after the index intervention. Results: Overall, 69 scaffolds were implanted in the 53 lesions, with 100% technical success. There were no deaths within 30 days of the index procedure. The primary patency rates at 6 and 12 months were 95% and 86%, respectively. The corresponding rates of freedom from CD-TLR were 98% and 93%, respectively. Freedom from major amputation was 98% at both time points, and amputation-free survival was 93% and 85% at 6 and 12 months after the index procedure. Wound healing occurred in 31 patients (79%) with Rutherford category 5/6 ischemia by the end of 12 months. Conclusion: The Absorb BVS demonstrated good 1-year patency and clinical outcomes in CLTI patients with complex infrapopliteal disease.


Subject(s)
Absorbable Implants , Cardiovascular Agents/administration & dosage , Endovascular Procedures/instrumentation , Everolimus/administration & dosage , Ischemia/therapy , Peripheral Arterial Disease/therapy , Popliteal Artery , Aged , Amputation, Surgical , Asian People , Cardiovascular Agents/adverse effects , Chronic Disease , Endovascular Procedures/adverse effects , Everolimus/adverse effects , Female , Humans , Ischemia/diagnostic imaging , Ischemia/ethnology , Limb Salvage , Male , Middle Aged , Peripheral Arterial Disease/diagnostic imaging , Peripheral Arterial Disease/ethnology , Popliteal Artery/diagnostic imaging , Popliteal Artery/physiopathology , Prosthesis Design , Registries , Retrospective Studies , Risk Factors , Singapore , Time Factors , Treatment Outcome , Vascular Patency , Wound Healing
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