Current practices of Asia-Pacific cardiologists in the utilization of bioresorbable scaffolds.

BACKGROUND & AIMS: Although Absorb Bioresorbable Vascular Scaffolds (A-BVS) are routinely used in the Asia-Pacific, there is little information on patient selection or deployment technique here. This document investigates the experiences of leading interventional cardiologists from the Asia-Pacific region with a focus on patient characteristics, deployment techniques and management. METHODS AND RESULTS: A detailed questionnaire was distributed to 28 highly-experienced interventional cardiologists ('Authors') from 13 Asia-Pacific countries. The results were discussed at a meeting on patient selection, technical consideration, deployment practices and patient management. Potential patient benefits of Absorb compared to metallic DES, the learning curve for patient selection and preparation, device deployment, and subsequent patient management approaches are presented. CONCLUSIONS: Current practices are derived from guidelines optimized for European patients. Differences in approach exist in the Asia-Pacific context, including limited access to imaging and frequency of occurrence of complex lesions. Nevertheless, the use of the Absorb BVS ('Absorb') in certain Asia-Pacific countries has flourished and practices here are continuing to mature.

Diagnostic value of 64-slice multi-detector row cardiac CTA in symptomatic patients.

Cardiac multi-detector-row computed tomography (MDCT) angiography has shown high levels of sensitivity and especially negative predictive value regarding the diagnosis of coronary artery disease (CAD). This study was designed to determine the value of a 64-slice-MDCT scanner in comparison to invasive coronary angiography for the detection of CAD in a population of symptomatic patients. Fifty-one patients with suspected CAD underwent conventional coronary angiography and ECG-gated cardiac 64-slice-MDCT angiography with a rotation time of 330 ms, a collimation of 64x0.6 mm and a slice thickness of 0.75 mm. Blinded patient- and segment-based analysis was performed for the detection of stenoses >or=70% of the vessel lumen. 95% of all coronary segments were assessable by MDCT angiography. Patient-based (segment-based) analysis revealed a sensitivity of 97.8% (86.7%), specificity of 50% (95.2%), positive predictive value of 93.6% (75.2%) and negative predictive value of 75% (97.7%). Inter-rater agreement revealed a kappa-value of 0.558 (0.722). In this symptomatic patient group a 64-slice-MDCT scanner shows good agreement on a segment-based analysis but only moderate agreement on a patient-based analysis. The diagnostic accuracy of 64-slice-MDCT coronary angiography is negatively influenced by the high pre-test probability of this symptomatic patient collective.