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Coronary Artery Disease: HELP
Articles by Jiang Ming Fam
Based on 11 articles published since 2010
(Why 11 articles?)
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Between 2010 and 2020, J. M. Fam wrote the following 11 articles about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Article Age and diabetes mellitus associated with worse outcomes after percutaneous coronary intervention in a multi-ethnic Asian dialysis patient population. 2020

Fam, Jiang Ming / Khoo, Chun Yuan / Lau, Yee How / Lye, Weng Kit / Cai, Xinzhe James / Choong, Lina Hui Lin / Allen, John Carson / Yeo, Khung Keong. ·Department of Cardiology, National Heart Centre Singapore, Singapore. · Duke-NUS Medical School, Singapore. · Department of Nephrology, Singapore General Hospital, Singapore. ·Singapore Med J · Pubmed #32179924.

ABSTRACT: INTRODUCTION: There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society. METHODS: A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction (AMI) and stroke at two years. RESULTS: 274 patients (65.0% male, median age 62.0 years) with 336 lesions (81.8% Type B2) were treated. 431 stents (35.0% drug-eluting stents) with a mean diameter of 2.96 mm and mean length of 21.30 mm were implanted. The MACE rate was 55.8% (n = 153) at two years, from death (36.5%) and AMI (35.0%). In multivariable analysis, age and diabetes mellitus were significant predictors of both mortality (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.05-1.12, p < 0.001; OR 2.65, 95% CI 1.46-4.82, p = 0.001, respectively) and MACE (OR 1.06, 95% CI 1.03-1.08, p < 0.001; OR 1.84, 95% CI 1.07-3.15, p = 0.027, respectively). Left ventricular ejection fraction (LVEF) (OR 0.97, 95% CI 0.95-0.99, p = 0.006) was a significant predictor of mortality but not MACE. CONCLUSION: Asian dialysis patients who underwent PCI had a two-year MACE rate of 55.8% due to death and AMI. Age, LVEF and diabetes mellitus were significant predictors of mortality at two years.

2 Article Advanced analyses of computed tomography coronary angiography can help discriminate ischemic lesions. 2018

Zhang, Jun-Mei / Shuang, Dongsi / Baskaran, Lohendran / Wu, Weijun / Teo, Soo-Kng / Huang, Weimin / Gobeawan, Like / Allen, John Carson / Tan, Ru San / Su, Xi / Ismail, Nasrul Bin / Wan, Min / Su, Boyang / Zou, Hua / Low, Ris / Zhao, Xiaodan / Chi, Yanling / Zhou, Jiayin / Su, Yi / Lomarda, Aileen Mae / Chin, Chee Yang / Fam, Jiang Ming / Keng, Felix Yung Jih / Wong, Aaron Sung Lung / Tan, Jack Wei Chieh / Yeo, Khung Keong / Wong, Philip En Hou / Chin, Chee Tang / Ho, Kay Woon / Yap, Jonathan / Kassab, Ghassan S / Chua, Terrance / Koh, Tian Hai / Tan, Swee Yaw / Lim, Soo Teik / Zhong, Liang. ·National Heart Center Singapore, 5 Hospital Drive, 169609, Singapore; Duke-NUS Medical School, 8 College Rd, 169857, Singapore. · Wuhan Asia Heart Hospital, 753 Jinghan Dadao, Wuhan 138632, Hubei, China. · National Heart Center Singapore, 5 Hospital Drive, 169609, Singapore. · National Heart Center Singapore, 5 Hospital Drive, 169609, Singapore; Nanchang University, Nanchang 330031, Jiangxi, China. · Institute of High Performance Computing, Agency for Science, Technology and Research, 138632, Singapore. · Institute for Infocomm Research, Agency for Science, Technology and Research, 138632, Singapore. · Duke-NUS Medical School, 8 College Rd, 169857, Singapore. · California Medical Innovations Institute, San Diego, CA 92121, USA. · National Heart Center Singapore, 5 Hospital Drive, 169609, Singapore; Duke-NUS Medical School, 8 College Rd, 169857, Singapore. Electronic address: lim.soo.teik@singhealth.com.sg. · National Heart Center Singapore, 5 Hospital Drive, 169609, Singapore; Duke-NUS Medical School, 8 College Rd, 169857, Singapore. Electronic address: zhong.liang@nhcs.com.sg. ·Int J Cardiol · Pubmed #29685695.

ABSTRACT: BACKGROUND: Computed tomography coronary angiography (CTCA) image analysis enables plaque characterization and non-invasive fractional flow reserve (FFR) calculation. We analyzed various parameters derived from CTCA images and evaluated their associations with ischemia. METHODS: 49 (61 lesions) patients underwent CTCA and invasive FFR. Lesions with diameter stenosis (DS) ≥ 50% were considered obstructive. CTCA image processing incorporating analytical and numerical methods were used to quantify anatomical parameters of lesion length (LL) and minimum lumen area (MLA); plaque characteristic parameters of plaque volume, low attenuation plaque (LAP) volume, dense calcium volume (DCV), normalized plaque volume (NP Vol), plaque burden, eccentricity index and napkin-ring (NR) sign; and hemodynamic parameters of resistance index, stenosis flow reserve (SFR) and FFR RESULTS: Plaque burden and plaque volume were inversely related to FFR. Multivariable logistic regression analysis identified the best anatomical, plaque and hemodynamic predictors, respectively, as DS (≥50% vs <50%; OR: 8.0; 95% CI: 1.6-39.4), normalized plaque volume (NP Vol) (≥4.3 vs <4.3; OR: 3.9; 95% CI: 1.1-14.0) and NR Sign (0 vs 1; OR: 13.6; 95% CI: 1.3-146.1), and FFR CONCLUSION: Normalized plaque volume, napkin-ring derived from plaque analysis, and FFR

3 Article Impact of calcium on procedural and clinical outcomes in lesions treated with bioresorbable vascular scaffolds - A prospective BRS registry study. 2017

Fam, Jiang Ming / Felix, Cordula / Ishibashi, Yuki / Onuma, Yoshinobu / Diletti, Roberto / Van Mieghem, Nicolas M / Regar, Evelyn / De Jaegere, Peter / Zijlstra, Felix / van Geuns, Robert Jan M. ·Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands; National Heart Centre Singapore, Singapore. · Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. · University Hospital Zürich, Switzerland. · Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. Electronic address: r.vangeuns@erasmusmc.nl. ·Int J Cardiol · Pubmed #28943146.

ABSTRACT: BACKGROUND: There is limited data on the impact of calcium (Ca) on acute procedural and clinical outcomes in patients with lesions treated with bioresorbable vascular scaffolds (BRS). We sought to evaluate the effect of calcium on procedural and clinical outcomes in a 'real world' population. METHODS: Clinical outcomes were compared between patients with at least 1 moderately or heavily calcified lesion (Ca) and patients with no/mild calcified lesions (non-Ca) enrolled in our institutional BRS registry. RESULTS: 455 patients (N) with 548 lesions (L) treated with 735 BRS were studied. Patients in the Ca group (N=160, L=200) had more complex (AHA B2/C lesion: 69.0% in Ca vs 14.9% in non-Ca, p<0.001) and significantly longer lesions (27.80±15.27 vs 19.48±9.92mm, p<0.001). Overall device success rate was 99.1% with no significant differences between the groups. Despite more aggressive lesion preparation and postdilation compared to non Ca, acute lumen gain was significantly less in Ca lesions (1.50±0.66 vs 1.62±0.69mm, p=0.040) with lower final MLD (2.28±0.41 vs 2.36±0.43, p=0.046). There were no significant differences in all-cause mortality, total definite scaffold thrombosis (ST), target lesion revascularization and myocardial infarction between the 2 groups. Late ST was more frequent in the Ca group compared to non Ca group (late ST: 2.1 vs 0%, p=0.02). CONCLUSIONS: Clinical outcomes after BRS implantation in calcified and non-calcified lesions were similar. A remarkable difference in timing of thrombosis was observed, with an increased rate of late thrombosis in calcified lesions.

4 Article Conformability in everolimus-eluting bioresorbable scaffolds compared with metal platform coronary stents in long lesions. 2017

Fam, Jiang Ming / Ishibashi, Yuki / Felix, Cordula / Zhang, Bu Chun / Diletti, Roberto / van Mieghem, Nicolas / Regar, Evelyn / van Domburg, Ron / Onuma, Yoshinobu / van Geuns, Robert-Jan. ·Department of Cardiology, Thorax Centre, Room Ba-585, Erasmus University Medical Centre, 's-Gravendijkwal 230, 3015 GE, Rotterdam, The Netherlands. · National Heart Centre, Singapore, Singapore. · The Affiliated Hospital of Xuzhou Medical College, Xuzhou, Jiangsu, China. · Department of Cardiology, Thorax Centre, Room Ba-585, Erasmus University Medical Centre, 's-Gravendijkwal 230, 3015 GE, Rotterdam, The Netherlands. r.vangeuns@erasmusmc.nl. ·Int J Cardiovasc Imaging · Pubmed #28685314.

ABSTRACT: The aim of this study was to determine if there are significant differences in curvature of the treated vessel after the deployment of a polymeric BRS or MPS in long lesions. The impact of long polymeric bioresorbable scaffolds (BRS) compared with metallic platform stents (MPS) on vessel curvature is unknown. This retrospective study compares 32 patients who received a single everolimus-eluting BRS with 32 patients treated with a single MPS of 28 mm. Quantitative coronary angiography (QCA) was used to evaluate curvature of the treatment and peri-treatment region before and after percutaneous coronary intervention (PCI). Baseline demographic and angiographic characteristics were similar between the BRS and MPS groups. Pretreatment lesion length was 22.19 versus 20.38 mm in the BRS and MPS groups respectively (p = 0.803). After treatment, there was a decrease in median diastolic curvature in the MPS group (from 0.257 to 0.199 cm

5 Article Everolimus-eluting bioresorbable vascular scaffolds for treatment of complex chronic total occlusions. 2017

Fam, Jiang Ming / Ojeda, Soledad / Garbo, Roberto / Latib, Azeem / La Manna, Alessio / Vaquerizo, Beatriz / Boukhris, Marouane / Vlachojannis, Georgios J / van Geuns, Robert-Jan / Ezhumalai, Babu / Kawamoto, Hiroyoshi / van der Sijde, Jors / Felix, Cordula / Pan, Manuel / Serdoz, Roberta / Boccuzzi, Giacomo Giovanni / De Paolis, Marcella / Sardella, Gennaro / Mancone, Massimo / Tamburino, Corrado / Smits, Pieter C / Di Mario, Carlo / Seth, Ashok / Serra, Antonio / Colombo, Antonio / Serruys, Patrick / Galassi, Alfredo R / Zijlstra, Felix / Van Mieghem, Nicolas M / Diletti, Roberto. ·National Heart Centre Singapore, Singapore. ·EuroIntervention · Pubmed #28218604.

ABSTRACT: AIMS: Bioresorbable vascular scaffolds (BVS) represent a novel therapeutic option for the treatment of coronary artery diseases. The objective of this study was to evaluate the feasibility of BVS implantation in complex chronic total occlusions (CTO). METHODS AND RESULTS: The present report is a multicentre registry evaluating results after BVS deployment in challenging CTO lesions, defined as J-CTO score ≥2 (difficult or very difficult). A total of 105 patients were included in the present analysis. The mean J-CTO score was 2.61 (difficult 52.4%, very difficult 47.6%). Device success and procedural success rates were 98.1% and 97.1%, respectively. The retrograde approach was used in 25.7% of cases. After wire crossing, predilatation was performed in all cases with a mean predilatation balloon diameter of 2.73±0.43 mm. The mean scaffold length was 59.75±25.85 mm, with post-dilatation performed in 89.5% of the cases and a mean post-dilatation balloon diameter of 3.35±0.44 mm. Post-PCI minimal lumen diameter was 2.50±0.51 mm and percentage diameter stenosis 14.53±10.31%. At six-month follow-up, a total of three events were reported: one periprocedural myocardial infarction, one late scaffold thrombosis and one additional target lesion revascularisation. CONCLUSIONS: The present report suggests the feasibility of BVS implantation in complex CTO lesions, given adequate lesion preparation and post-dilatation, with good acute angiographic results and midterm clinical outcomes.

6 Article Expanded clinical use of everolimus eluting bioresorbable vascular scaffolds for treatment of coronary artery disease. 2017

Diletti, Roberto / Ishibashi, Yuki / Felix, Cordula / Onuma, Yoshinobu / Nakatani, Shimpei / van Mieghem, Nicolas M / Regar, Eveliyn / Valgimigli, Marco / de Jaegere, Peter P / van Ditzhuijzen, Nienke / Fam, Jiang Ming / Ligthart, Jurgen M R / Lenzen, Mattie J / Serruys, Patrick W / Zijlstra, Felix / Jan van Geuns, Robert. ·Thoraxcenter Erasmus MC, Rotterdam, The Netherlands. · Cardialysis BV, Rotterdam, The Netherlands. ·Catheter Cardiovasc Interv · Pubmed #27896897.

ABSTRACT: BACKGROUND: Limited data are currently available on the performance of everolimus eluting bioresorbable vascular scaffold (BVS) for treatment of complex coronary lesions representative of daily practice. METHODS: This is a prospective, mono-center, single-arm study, reporting data after BVS implantation in patients presenting with stable, unstable angina, or non-ST segment elevation myocardial infarction caused by de novo stenotic lesions in native coronary arteries. No restrictions were applied to lesion complexity. Procedural results and 12-month clinical outcomes were reported. RESULTS: A total of 180 patients have been evaluated in the present study, with 249 treated coronary lesions. Device Success per lesion was 99.2%. A total of 119 calcified lesions were treated. Comparable results were observed among severe, moderate and noncalcified lesions in term of %diameter stenosis (%DS) (20.3 ± 10.5%, 17.8 ± 7.7%, 16.8 ± 8.6%; P = 0.112) and acute gain (1.36 ± 0.41 mm, 1.48 ± 0.44 mm, 1.56 ± 0.54 mm; P = 0.109). In bifurcations (54 lesions), side-branch ballooning after main vessel treatment was often performed (33.3%) with low rate of side-branch impairment (9.3%). A total of 29 cases with coronary total occlusions were treated. After BVS implantation %DS was not different from other lesion types (17.2 ± 9.4%, vs. 17.7 ± 8.6%; P = 0.780). At one year, all-cause mortality was reported in three cases. The rate of target lesion revascularization and target vessel revascularization was 3.3%. The rate of definite scaffold thrombosis was 2.6%. CONCLUSIONS: The implantation of the everolimus eluting bioresorbable vascular scaffold in an expanded range of coronary lesion types and clinical presentations was observed to be feasible with promising angiographic results and mid-term clinical outcomes. © 2016 Wiley Periodicals, Inc.

7 Article Optimization of coronary optical coherence tomography imaging using the attenuation-compensated technique: a validation study. 2017

Teo, Jing Chun / Foin, Nicolas / Otsuka, Fumiyuki / Bulluck, Heerajnarain / Fam, Jiang Ming / Wong, Philip / Low, Fatt Hoe / Leo, Hwa Liang / Mari, Jean-Martial / Joner, Michael / Girard, Michael J A / Virmani, Renu. ·National Heart Research Institute Singapore, National Heart Centre Singapore, 5 Hospital Drive, Singapore 169609. · Department of Biomedical Engineering and Duke-NUS Medical School, National University Singapore, Singapore. · CV Path Institute, Gaithersburg, MD, USA. · National Cerebral and Cardiovascular Center, Osaka, Japan. · Department of Cardiology, National University Heart Center, Singapore. · University of French Polynesia, French Polynesia. · Singapore Eye Research Institute Singapore National Eye Centre, Singapore. ·Eur Heart J Cardiovasc Imaging · Pubmed #27469587.

ABSTRACT: Aim: To optimize conventional coronary optical coherence tomography (OCT) images using the attenuation-compensated technique to improve identification of plaques and the external elastic lamina (EEL) contour. Methods and Results: The attenuation-compensated technique was optimized via manipulating contrast exponent C, and compression exponent N, to achieve an optimal contrast and signal-to-noise ratio (SNR). This was applied to 60 human coronary lesions (38 native and 22 stented) ex vivo conventional coronary OCT images acquired from heart autopsies of 10 patients and matching histology was available as reference. Three independent reviewers assessed the conventional and attenuation-compensated OCT images blindly for plaque characteristics and EEL detection. Conventional OCT and compensated OCT assessment were compared against histology. Using an optimized algorithm, the attenuation-compensated OCT images had a 2-fold improvement in contrast between different tissues in both stented and non-stented epicardial coronaries (P < 0.05). Overall sensitivity and specificity for plaque classification increased from 84 to 89% and from 92 to 94%, respectively, with substantial agreement among the three reviewers (Fleiss' Kappa k, 0.72 and 0.71, respectively). Furthermore, operators were 2.5 times more likely to identify the EEL contour in the attenuation-compensated OCT images (k = 0.72) than in the conventional OCT images (k = 0.36). Conclusion: The attenuation-compensated technique can be retrospectively applied to conventional OCT images and improves the detection of plaque characteristics and the EEL contour. This approach could complement conventional OCT imaging in the evaluation of plaque characteristics and quantify plaque burden in the clinical setting.

8 Article Safety of optical coherence tomography in daily practice: a comparison with intravascular ultrasound. 2017

van der Sijde, Johannes N / Karanasos, Antonios / van Ditzhuijzen, Nienke S / Okamura, Takayuki / van Geuns, Robert-Jan / Valgimigli, Marco / Ligthart, Jurgen M R / Witberg, Karen T / Wemelsfelder, Saskia / Fam, Jiang Ming / Zhang, BuChun / Diletti, Roberto / de Jaegere, Peter P / van Mieghem, Nicolas M / van Soest, Gijs / Zijlstra, Felix / van Domburg, Ron T / Regar, Evelyn. ·Thoraxcenter, Erasmus MC, Bd 585, 's-Gravendijkwal 230, 3015-CE Rotterdam, The Netherlands. · Department of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan. · National Heart Centre Singapore, Singapore. · Department of Cardiology, The Affiliated Hospital of Xuzhou Medical College, Jiangsu, China. ·Eur Heart J Cardiovasc Imaging · Pubmed #26992420.

ABSTRACT: Aims: Previous studies have reported the safety and feasibility of both time-domain optical coherence tomography (TD-OCT) and Fourier-domain OCT (FD-OCT) in highly selected patients and clinical settings. However, the generalizability of these data is limited, and data in unselected patient populations reflecting a routine cathlab practice are lacking. We compared safety of intracoronary FD-OCT imaging to intravascular ultrasound (IVUS) imaging in a large real-world series of consecutive patients who underwent invasive imaging during coronary catheterization in our centre. Methods and results: This is a prospective, single-centre registry of patients scheduled for coronary angiography or intervention undergoing intracoronary imaging with FD-OCT or IVUS between April 2008 and December 2013. Intra-procedural and major in-hospital adverse events that could be possibly related to invasive imaging were registered routinely by the operator as part of our clinical report and prospectively recorded in our database. These events were retrospectively individually adjudicated by an independent safety committee. Between April 2008 and December 2013, 13 418 diagnostic or interventional coronary catheterization procedures were performed. Of these, 1142 procedures used OCT and 2476 procedures used IVUS. Invasive imaging-related complications were rare, did not differ between the two imaging methods (OCT: n = 7, 0.6%; IVUS: n = 12, 0.5%; P = 0.6), and were self-limiting after retrieval of the imaging catheter or easily treatable in the catheterization laboratory. No major adverse events, prolongation of hospital stay, or permanent patient harm was observed. Conclusion: FD-OCT is safe in an unselected and heterogeneous group of patients with varying clinical settings.

9 Article Mid- to Long-Term Clinical Outcomes of Patients Treated With the Everolimus-Eluting Bioresorbable Vascular Scaffold: The BVS Expand Registry. 2016

Felix, Cordula M / Fam, Jiang Ming / Diletti, Roberto / Ishibashi, Yuki / Karanasos, Antonios / Everaert, Bert R C / van Mieghem, Nicolas M D A / Daemen, Joost / de Jaegere, Peter P T / Zijlstra, Felix / Regar, Evelyn S / Onuma, Yoshinobu / van Geuns, Robert-Jan M. ·Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. · Thoraxcenter, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: r.vangeuns@erasmusmc.nl. ·JACC Cardiovasc Interv · Pubmed #27476094.

ABSTRACT: OBJECTIVES: This study sought to report on clinical outcomes beyond 1 year of the BVS Expand registry. BACKGROUND: Multiple studies have proven feasibility and safety of the Absorb bioresorbable vascular scaffold (BVS) (Abbott Vascular, Santa Clara, California). However, data on medium- to long-term outcomes are limited and available only for simpler lesions. METHODS: This is an investigator-initiated, prospective, single-center, single-arm study evaluating performance of the BVS in a lesion subset representative of daily clinical practice, including calcified lesions, total occlusions, long lesions, and small vessels. Inclusion criteria were patients presenting with non-ST-segment elevation myocardial infarction, stable/unstable angina, or silent ischemia caused by a de novo stenotic lesion in a native previously untreated coronary artery. Procedural and medium- to long-term clinical outcomes were assessed. Primary endpoint was major adverse cardiac events, defined as a composite of cardiac death, myocardial infarction, and target lesion revascularization. RESULTS: From September 2012 to January 2015, 249 patients with 335 lesions were enrolled. Mean number of scaffolds per patient was 1.79 ± 1.15. Invasive imaging was used in 39%. In 38.1% there were American College of Cardiology/American Heart Association classification type B2/C lesions. Mean lesion length was 22.16 ± 13.79 mm. Post-procedural acute lumen gain was 1.39 ± 0.59 mm. Median follow-up period was 622 (interquartile range: 376 to 734) days. Using Kaplan-Meier methods, the MACE rate at 18 months was 6.8%. Rates of cardiac mortality, myocardial infarction, and target lesion revascularization at 18 months were 1.8%, 5.2%, and 4.0%, respectively. Definite scaffold thrombosis rate was 1.9%. CONCLUSIONS: In our study, BVS implantation in a complex patient and lesion subset was associated with an acceptable rate of adverse events in the longer term, whereas no cases of early thrombosis were observed.

10 Article Everolimus-eluting bioresorbable vascular scaffolds implanted in coronary bifurcation lesions: Impact of polymeric wide struts on side-branch impairment. 2016

De Paolis, Marcella / Felix, Cordula / van Ditzhuijzen, Nienke / Fam, Jiang Ming / Karanasos, Antonis / de Boer, Sanneke / van Mieghem, Nicolas M / Daemen, Joost / Costa, Francesco / Bergoli, Luis Carlos / Ligthart, Jurgen M R / Regar, Evelyn / de Jaegere, Peter P / Zijlstra, Felix / van Geuns, Robert Jan / Diletti, Roberto. ·Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. · Department of Interventional Cardiology, Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands. Electronic address: r.diletti@erasmusmc.nl. ·Int J Cardiol · Pubmed #27423087.

ABSTRACT: BACKGROUND: Limited data are available on bioresorbable vascular scaffolds (BVS) performance in bifurcations lesions and on the impact of BVS wider struts on side-branch impairment. METHODS: Patients with at least one coronary bifurcation lesion involving a side-branch ≥2mm in diameter and treated with at least one BVS were examined. Procedural and angiographic data were collected and a dedicated methodology for off-line quantitative coronary angiography (QCA) in bifurcation was applied (eleven-segment model), to assess side-branch impairment occurring any time during the procedure. Two- and three-dimensional QCA were used. Optical coherence tomography (OCT) analysis was performed in a subgroup of patients and long-term clinical outcomes reported. RESULTS: A total of 102 patients with 107 lesions, were evaluated. Device- and procedural-successes were 99.1% and 94.3%, respectively. Side-branch impairment occurring any time during the procedure was reported in 13 bifurcations (12.1%) and at the end of the procedure in 6.5%. Side-branch minimal lumen diameter (Pre: 1.45±0.41mm vs Final: 1.48±0.42mm, p=0.587) %diameter-stenosis (Pre: 26.93±16.89% vs Final: 27.80±15.57%, p=0.904) and minimal lumen area (Pre: 1.97±0.89mm(2) vs Final: 2.17±1.09mm(2), p=0.334), were not significantly affected by BVS implantation. Mean malapposed struts at the bifurcation polygon-of-confluence were 0.63±1.11. CONCLUSIONS: The results of the present investigation suggest feasibility and relative safety of BVS implantation in coronary bifurcations. BVS wide struts have a low impact on side-branch impairment when considering bifurcations with side-branch diameter≥2mm.

11 Article Are BVS suitable for ACS patients? Support from a large single center real live registry. 2016

Felix, C M / Onuma, Y / Fam, J M / Diletti, R / Ishibashi, Y / Karanasos, A / Everaert, B R C / van Mieghem, N M D A / Daemen, J / de Jaegere, P P T / Zijlstra, F / Regar, E S / van Geuns, R J M. ·Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands. · Thoraxcenter, Erasmus MC, s-Gravendijkwal 230, 3015 CE, Rotterdam, the Netherlands. Electronic address: r.vangeuns@erasmusmc.nl. ·Int J Cardiol · Pubmed #27232918.

ABSTRACT: OBJECTIVES: To investigate one-year outcomes after implantation of a bioresorbable vascular scaffold (BVS) in patients presenting with acute coronary syndrome (ACS) compared to stable angina patients. BACKGROUND: Robust data on the outcome of BVS in the setting of ACS is still scarce. METHODS: Two investigator initiated, single-center, single-arm BVS registries have been pooled for the purpose of this study, namely the BVS Expand and BVS STEMI registries. RESULTS: From September 2012-October 2014, 351 patients with a total of 428 lesions were enrolled. 255 (72.6%) were ACS patients and 99 (27.4%) presented with stable angina/silent ischemia. Mean number of scaffold/patient was 1.55±0.91 in ACS group versus 1.91±1.11 in non-ACS group (P=0.11). Pre- and post-dilatation were performed less frequent in ACS patients, 75.7% and 41.3% versus 89.0% and 62.0% respectively (P=0.05 and P=0.001). Interestingly, post-procedural acute lumen gain and percentage diameter stenosis were superior in ACS patients, 1.62±0.65mm (versus 1.22±0.49mm, P<0.001) and 15.51±8.47% (versus 18.46±9.54%, P=0.04). Major adverse cardiac events (MACE) rate at 12months was 5.5% in the ACS group (versus 5.3% in stable group, P=0.90). One-year definite scaffold thrombosis rate was comparable: 2.0% for ACS population versus 2.1% for stable population (P=0.94), however, early scaffold thromboses occurred only in ACS patients. CONCLUSIONS: One-year clinical outcomes in ACS patients treated with BVS were similar to non-ACS patients. Acute angiographic outcomes were better in ACS than in non-ACS, yet the early thrombotic events require attention and further research.