Acute mechanical performance of bioresorbable scaffolds compared with everolimus-eluting stents under optical coherence tomography guidance

Objective The aim was to compare the acute mechanical performance of the ABSORB bioresorbable scaffold (BRS) with the everolimus-eluted stents (EES) after optical coherence tomography (OCT)-guided deployment. Background The intrinsic differences in biomechanical properties between BRS and EES and the thicker BRS struts can affect the BRS acute mechanical performance in terms of scaffold expansion and struts apposition. Materials and methods The authors compared the acute mechanical performance of 245 scaffolds with that of 82 everolimus-eluted EES. All scaffolds/stents were deployed under OCT guidance. OCT was used to assess the following acute mechanical performance indices: residual area stenosis, device underexpansion, struts malapposition, edge dissection whether covered or uncovered, and strut fracture. Results Two hundred forty-five scaffolds implanted in 162 patients in the BRS arm were compared with 82 stents implanted in 61 patients in the EES arm. Final OCT acquisitions showed no statistically significant difference in the acute mechanical performance indices between both arms, in terms of residual area stenosis, device underexpansion, struts malapposition, and struts fracture. The only significant difference was noted in the higher rates of both covered and uncovered edge dissections in the BRS arm. Conclusion Under OCT guidance, there was no significant difference in the acute mechanical performance of BRS vs EES, apart from higher rates of both covered and uncovered edge dissections in the BRS arm.