Author + information
- Received December 13, 2012
- Revision received January 8, 2013
- Accepted January 18, 2013
- Published online January 1, 2014.
- Christos V. Bourantas, MD, PhD∗,
- Michail I. Papafaklis, MD, PhD†,
- Hector M. Garcia-Garcia, MD, PhD∗,
- Vasim Farooq, MBChB∗,
- Roberto Diletti, MD∗,
- Takashi Muramatsu, MD, PhD∗,
- Yaojun Zhang, MD, PhD∗,
- Fanis G. Kalatzis, PhD‡,
- Katerina K. Naka, MD, PhD§,
- Dimitrios I. Fotiadis, PhD‡,
- Yoshinobu Onuma, MD∗,
- Lampros K. Michalis, MD§ and
- Patrick W. Serruys, MD, PhD∗∗ ()
- ∗ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands
- †Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
- ‡Department of Materials Science and Engineering, University of Ioannina, Ioannina, Greece
- §Department of Cardiology, University of Ioannina, Ioannina, Greece
- ↵∗Reprint requests and correspondence:
Dr. Patrick W. Serruys, ThoraxCenter, Erasmus MC’s-Gravendijkwal 230, 3015 CE Rotterdam, the Netherlands.
The angiographic and optical coherence tomographic data acquired at baseline and at 2-year follow-up from a 59-year-old patient, who had been implanted with an Absorb bioresorbable vascular scaffold (Absorb BVS, Abbott Vascular, Santa Clara, California), were fused to reconstruct the coronary anatomy of the treated left anterior descending artery (1). Blood flow simulation was performed and the endothelial shear stress (ESS) was computed at these 2 time points and portrayed on the luminal surface with the use of a color-coded map (Fig. 1) (2). The rugged surface created at baseline following scaffold implantation resulted in predominantly low ESS (62.6% of the segment had ESS <1 Pa) that predisposed to neointimal formation. At 2-year follow-up, the ESS distribution was normalized and only 16.5% of the scaffolded segment had ESS <1 Pa, whereas the developed neointima had a mean thickness of 160 μm and covered the vessel wall.
This case highlights the short- and long-term implications of an Absorb BVS implantation on the local ESS patterns. The low ESS detected after device implantation is likely to contribute to neointimal formation that smooths the luminal surface and normalizes the ESS. At follow-up, the scaffolded segment is predominantly exposed to an atheroprotective hemodynamic environment; has restored its geometry, physiologic function, and vasomotion; and is covered by a thin layer of neointima that seals the underlying plaques (3). The prognostic implications of these findings and the potential value of the Absorb BVS in the invasive passivation of potential vulnerable plaques require further investigation.
The ABSORB Cohort B Study was sponsored by Abbott Vascular. Dr. Naka's research group has received grants from Menerini and the Hellenic Cardiological Society. Dr. Michalis has received grants from the Hellenic Cardiological Society and the Greek Ministry of Development. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received December 13, 2012.
- Revision received January 8, 2013.
- Accepted January 18, 2013.
- American College of Cardiology Foundation