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  • Multianalysis with optical coherence tomography and vasomotion in everolimus-eluting stents and everolimus-eluting biovascular scaffolds: the MOVES trial

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Interventional cardiology
Original research article
Multianalysis with optical coherence tomography and vasomotion in everolimus-eluting stents and everolimus-eluting biovascular scaffolds: the MOVES trial
  1. Diego A Arroyo,
  2. Sara Schukraft,
  3. Zacharenia Kallinikou,
  4. Jean-Christophe Stauffer,
  5. Gérard Baeriswyl,
  6. Jean-Jacques Goy,
  7. Mario Togni,
  8. Stéphane Cook and
  9. Serban Puricel
  1. Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland
  1. Correspondence to Dr Serban Puricel; serbanpuricel{at}icloud.com

Abstract

Aims To compare endothelium-dependent vasomotor function and vascular healing 15 months after implantation of two new-generation drug-eluting stents and biovascular scaffolds (BVS).

Methods and results A total of 28 patients previously treated with a SYNERGY stent (bioabsorbable polymer everolimus-eluting stents (BP-EES)), a PROMUS stent (persistent polymer everolimus-eluting stents (PP-EES)) or an ABSORB (BVS) underwent control coronary angiography, 15 months after implantation, coupled with optical coherence tomography imaging and supine bicycle exercise. Intracoronary nitroglycerin was administered after exercise testing. Coronary vasomotor response was assessed using quantitative coronary angiography at rest, during supine bicycle exercise and after nitroglycerin. The primary end point was the percent change in mean lumen diameter compared with baseline. Secondary end points were strut coverage and apposition.

There were no significant differences in vasomotor response between the three treatment groups. Patients with PP-EES showed significant vasoconstriction of the proximal peristent segment at maximum exercise (P=0.02). BP-EES (2.7%, 95% CI 0 to 5.5) and BVS (3.2%, 95% CI 0 to 6.7) showed less uncovered struts than PP-EES (12.1%, 95% CI 2.9 to 21.3, P=0.02 and 0.09, respectively). Complete strut apposition was more frequently seen with BP-EES (99.6%, 95% CI 99.2 to 100) than with BVS (98.9%, 95% CI 98.2 to 99.6, P=0.04) or PP-EES (95.0%, 95% CI 91.6 to 98.5, P=0.001).

Conclusion BVS and thin strut BP-EES have a reassuring vasomotion profile, suggesting minimal endothelial dysfunction 15 months after implantation.

  • drug-eluting stent
  • bioresorbable vascular scaffold
  • percutaneous coronary intervention
  • optical coherence tomography

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/openhrt-2017-000624

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    Footnotes

    • DA and SS are co first authors

    • 26 SP and SC are co senior authors.

    • DAA and SS contributed equally,

    • SC and SP contributed equally.

    • Contributors DAA provided substantial contributions to the analysis of data for the work and was involved in drafting the manuscript and then revised it critically for important intellectual content and gave his final approval of the version to be published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SS provided substantial contributions to the acquisition and analysis of data for the work and was involved in drafting the manuscript and then revised it critically for important intellectual content and gave her final approval of the version to be published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. ZK provided substantial contributions to the acquisition and analysis of data for the work and revised the manuscript critically for important intellectual content and gave her final approval of the version to be published and agrees to be accountable for all aspects of thework in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. J-CS, GB and J-JG provided substantial contributions to conception of the work and the acquisition and interpretation of data for the work and revised the manuscript critically for important intellectual content and gave his final approval of the version to be published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. MT provided substantial contributions to conception and design of the work and the acquisition and interpretation of data for the work and revised the manuscript critically for important intellectual content and gave his final approval of the version to be published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SC provided substantial contributions to conception and design of the work and the acquisition, analysis and interpretation of data for the work and revised the manuscript critically for important intellectual content and gave his final approval of the version to be published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. SP provided substantial contributions to conception and design of the work and the acquisition, analysis and interpretation of data for the work and was involved in drafting the manuscript and then revised it critically for important intellectual content and gave his final approval of the version to be published and agrees to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Funding This trial was an investigator-initiated study supported by an unrestricted grant from the Fonds Scientifique Cardiovasculaire (Fribourg, Switzerland). During the study period, the Fonds Scientifique Cardiovasculaire received educational and research grants from Abbott Vascular and a dedicated unrestricted grant from Boston Scientific through the independent investigator research programme. SC received support from the Swiss National Science Foundation (CR32I3_150271/1).

    • Competing interests SC has received speaker fees/honoraria from Abbott Vascular, Biosensors International, and Boston Scientific.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval The study complied with the Declaration of Helsinki and was approved by the local ethics committee at University and Hospital Fribourg, Switzerland.

    • Provenance and peer review Not commissioned; externally peer reviewed.