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Geraci, Salvatore; Kawamoto, Hiroyoshi; Caramanno, Giuseppe; Ruparelia, Neil; Capodanno, Davide; Brugaletta, Salvatore; Gori, Tommaso; Nef, Holger; Sabate, Manel; Mehilli, Julinda; Lesiak, Maciej; Naber, Christoph; Mario, Carlo di; Capranzano, Piera; Wiebe, Jens; Araszkiewicz, Aleksander; Pyxaras, Stelios; Mattesini, Alessio; Muenzel, Thomas; Tamburino, Corrado; Colombo, Antonio; Latib, Azeem (2017): Bioresorbable Everolimus-Eluting Vascular Scaffold for Long Coronary Lesions A Subanalysis of the International, Multicenter GHOST-EU Registry. In: Jacc-Cardiovascular interventions, Vol. 10, No. 6: pp. 560-568
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Abstract

OBJECTIVES The authors sought to investigate 1-year outcomes in patients treated with bioresorbable everolimus-eluting vascular scaffolds (BVS) for "long coronary lesions." BACKGROUND The present substudy derived from the GHOST-EU registry included 1,722 lesions in 1,468 consecutive patients, enrolled between November 2011 and September 2014 at 11 European centers. METHODS The lesions were divided into 3 groups according to continuous BVS length: 1) shorter than 30 mm;2) between 30 and 60 mm;and 3) longer than 60 mm. Primary device-oriented endpoint (target lesion failure [TLF]) was defined as a combination of cardiovascular death, target vessel myocardial infarction, or clinically driven target lesion revascularization. RESULTS Patients with lesions >= 60 mm had more comorbidities and more complex lesion characteristics, including chronic total occlusions (37%), bifurcation lesions (40.3%), higher Syntax score (16.4 +/- 7.8), and higher number of scaffolds implanted per lesion (3.3 +/- 0.9 mm). The main target vessel was the left anterior coronary artery in all groups. Median follow-up was 384 (interquartile range: 359 to 459) days. One-year follow-up was completed in 70.3% of patients. TLF at 1 year was significantly higher in group C (group A 4.8%, group B 4.5%, group C 14.3%;overall p = 0.001), whereas there were no significant differences between groups A and B. Finally, a numerically higher (but not statistically significant) number of scaffold thromboses were observed in group C when compared with shorter lesions (group A 2.1%, group B 1.1%, group C 3.8%;overall p = 0.29). CONCLUSIONS In a real-world setting, treatment of long coronary lesions with BVS >= 60 mm was associated with a higher TLF rate, driven by myocardial infarction and clinically driven target lesion revascularization. (C) 2017 Published by Elsevier on behalf of the American College of Cardiology Foundation.