Radiation exposure during the implantation of bioabsorbable vascular scaffolds versus drug-eluting stents in non-complex coronary lesions: a matched-cohort study

BACKGROUND: Bioabsorbable vascular scaffolds (BVS) are a novel option for the treatment of coronary lesions in patients with stable coronary artery disease or acute coronary syndromes. We aimed to identify the influence of BVS implantation on radiation exposure and procedural outcomes compared to drug-eluting stents (DES) in daily clinical practice.

METHODS: A retrospective single-center study was performed in patients undergoing percutaneous coronary intervention with BVS from 2013 to 2014. Only patients with exclusive BVS implantation (N.=78 procedures) were compared with a 2:1 matched cohort of exclusive DES-treated patients in the same period (N.=156 procedures). We used a four-step protocol to reduce radiation exposure in all procedures. Furthermore, a 12-month clinical follow-up was performed.

RESULTS: Patients had similar baseline characteristics due to matching. Radiation exposure (1826 vs. 2167 cGy*cm2, P=0.673), procedure time (73 vs. 65 minutes, P=0.574), target vessel revascularization (1.3 vs. 1.3%, p=1.000 for PCI; 1.3 vs. 0.6%, P=0.616 for CABG), cardiovascular death (0.0 vs. 2.6%, P=0.304) or all-cause death (0.0 vs. 3.2%, P=0.172) were similar after implantation of BVS vs. DES. However, exposure to contrast agent (166 vs. 139 mL, P=0.028) was significantly higher in the BVS group.

CONCLUSIONS: The implantation of BVS in combination with a simple four-step protocol is a feasible option for interventional treatment of non-complex coronary lesions without significant impact on radiation exposure or outcome measures in daily clinical routine.