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Altres plataformes: situació actual Salvatore Brugaletta Hospital Clinic i Provincial, Barcelona

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Page 1: Hospital Clinic i Provincial, Barcelona€¦ · Hospital Clinic i Provincial, Barcelona CE-mark platforms No CE-mark platforms Altres plataformes: situacio ́ actual CE-mark platforms

Altres plataformes: situacio actual

Salvatore BrugalettaHospital Clinic i Provincial, Barcelona

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CE-mark platforms

No CE-mark platforms

Altres plataformes: situacio actual

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CE-mark platforms

No CE-mark platforms

Altres plataformes: situacio actual

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CE-mark approved bioresorbablescaffolds

Moderador
Notas de la presentación
Llama la atencio el grosor de estos dispositivos que es bastante mas que un stent metalico normal
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Mechanical properties

Reduced elasticity and strengthas compared to metallic stent

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DESolve innovation

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DESolve Nx TrialProspective one-arm study with 126 patients2-year clinical follow-up (122 patients)6-month QCA (113 patients) IVUS (40 patients)OCT follow-up (38 patients)

Abizaid JACC Intv 2016;9:565-74

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DESolve Nx Trial: 6-month late loss

0.20±0.32 mm

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DESolve Nx Trial: IVUS and OCT

Increase in scaffold area during 6-month

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DESolve Nx Trial: 2-year ClinicalOutcomes

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Fantom (Reva Medical Inc.)Optical properties comparison

Radiopaque platformEluting sirolimus

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FANTOM II study (240 patients)

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History of Magmaris scaffold

0.25±0.22

3.4

0.0

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BIOSOLVE-II first-in-man trial (n=123 pts)

One-year TLF 3.4%. No events beyond 6M. No definite/probable ST

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Magmaris vs. Absorb vs. OrsiroImmunofluorescence

Waksman R et al. Circulation Cardiovascular Interventions

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Magmaris vs. Absorb vs. OrsiroImmunofluorescence

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Magmaris vs. 316L-equivalentImmunofluorescence

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148 patients with STEMI (< 6 hrs)1:1 randomization

MAGMARIS CohortN = 74

ORSIRO CohortN = 74

Thrombectomy +/-predilatation

Scaffolding (M-BRS) Stenting (DES)

Sizing max

+/- postdilatation / thrombectomy based on angiographic guidance

Primary endpoint: vasodilatatory response ≥ 3% after nitroglycerininjection at 1-year FU

NTG injection, OCT evaluation (subgroup 40 pacients)

Thrombectomy +/-predilatation

NTG injection, OCT evaluation (subgroup 40 pacients)

MAGSTEMI trial

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CE-mark platforms

No CE-mark platforms

Altres plataformes: situacio actual

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Firesorb BRS (Microport)

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Clinical outcomes

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OCT Data

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MeRes 100 (Meril)

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MeRes-1 Study (108 pts, 116 lesions)

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MeRes-1 Study (108 pts, 116 lesions)

6-month OCT data 6-month Late loss

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APTITUDE Sirolimus-eluting BRS(Amaranth Medical)

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RENASCENT II study (60 Patients)

9-month late loss 0.19±0.26 mm

Low MACE rate (3.4%, due to 2 non-Q-wave

MI)

Scaffold stability as assessed by OCT lumen

area

High level of strut coverage (97%)

Colombo A EuroPCR 2017

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Take-Home Messages

Development of other bioresorbableplatforms is slow but active, showinginteresting and favourable data

Large and randomized trials are neededto evaluate its safety and to understandwhich patient may benefit most from thistechnology