RESUMO
OBJECTIVES: This study explores the safety and efficacy of thin strut MeRes100 sirolimus-eluting bioresorbable vascular scaffold (BRS) in patients with de novo coronary artery lesions. BACKGROUND: In interventional cardiology, the emergence of BRS technology is catalyzing the next paradigm shift. METHODS: The MeRes-1 Extend was a multicenter, prospective, single-arm, open-label study enrolling 64 patients in Spain, Macedonia, Brazil, South Africa, Malaysia, and Indonesia. The safety endpoint was major adverse cardiac events (MACE) which composed of cardiac death, myocardial infarction (MI), and ischemia-driven target lesion revascularization (ID-TLR). The imaging efficacy endpoint was mean in-scaffold late lumen loss (LLL) evaluated by quantitative coronary angiography (QCA). Optical coherence tomography (OCT) imaging was performed at baseline and 6-month follow-up. RESULTS: A total of 69 target lesions were identified in 64 enrolled patients (mean age 58.30 ± 9.02 years). Of the treated lesions, 49 (71.01%) lesions were of type B2/C. Procedural and device success was achieved in 64 and 62 patients, respectively. At 2-year follow-up, MACE was reported in one patient (1.61%) in the form of ID-TLR. There was no case of MI, cardiac death or scaffold thrombosis through 2-year. In a subset of 32 patients, paired QCA showed mean in-scaffold LLL of 0.18 ± 0.31 mm at 6-month follow-up. In a subset of 21 patients, OCT revealed 97.95 ± 3.69% strut coverage with mean scaffold area of 7.56 ± 1.79 mm2 and no evidence of strut malapposition. CONCLUSIONS: The clinical and imaging outcomes of MeRes-1 Extend trial demonstrated favorable safety and efficacy of MeRes100 sirolimus-eluting BRS in patients with de novo coronary artery lesions.
Assuntos
Angiografia Coronária , Tomografia de Coerência Óptica , Infarto do MiocárdioRESUMO
BACKGROUND: The development of bioresorbable vascular scaffold (BRS) offers a new treatment strategy for coronary artery lesion by replacement of a permanent metallic scaffold with a temporary scaffold and eradicating a nidus for very late adverse events. The first-in-human MeRes-1 trial reported favorable safety and efficacy of thin-strut (100 mm) MeRes100 sirolimus-eluting BRS (Meril Life Sciences Pvt. Ltd., India) in patients with de novo coronary artery lesions. Hence, to reaffirm the outcomes of the MeRes-1 trial, the MeRes-1 Extend trial sought to evaluate the safety and efficacy of the MeRes100 BRS in diverse patient population in Europe, Brazil, South Africa, and Asia Pacific. METHODS: The MeRes-1 Extend was a multicenter, prospective, single-arm study of MeRes100 BRS in 64 patients from Spain, Macedonia, Brazil, South Africa, Malaysia, and Indonesia. The safety endpoint was major adverse cardiac events (MACE), which composed of cardiac death, myocardial infarction (MI), and ischemia-driven target lesion revascularization (ID-TLR). Quantitative coronary angiography and optical coherence tomography (OCT) imaging was performed at baseline and 6-month follow-up. RESULTS: Among 64 enrolled patients (mean age: 58.30 _ 9.02 years), 26.56% had diabetes mellitus and 68.75% patients presented with stable angina. Of 69 target lesions, 71.01% were classified as type B2/C; average lesion length was 14.37 _ 5.89 mm and mean reference vessel diameter was 3.03 _ 0.35 mm. Procedural and device success was achieved in 64 and 62 patients, respectively. MACE was reported in 1 patient (1.61%) at 24-month follow-up in the form of ID-TLR with absence of MI, cardiac death, or scaffold thrombosis. At 6-month angiographic follow-up in a subset of 32 patients, mean in-scaffold LLL was 0.18 _ 0.31 mm. OCT analysis (n » 21) reported 97.95 _ 3.69% strut coverage with mean scaffold area of 7.56 _ 1.79 mm2 and no evidence of strut malapposition. CONCLUSION: Based on 2-year clinical and 6-month imaging outcomes, the MeRes-1 Extend trial established favorable safety and efficacy of MeRes100 sirolimus-eluting BRS in patients with de novo coronary artery lesions. (AU)
