Second-generation everolimus eluting bioresorbable vascular scaffold for treatment of patients presenting with acute coronary syndromes - insights from the Rotterdam EXPAND registry

Purpose: The second generation everolimus eluting vascular scaffold (BVS) has been evaluated in the ABSORB clinical trial program. Patients with acute coronary syndromes (ACS) were excluded from those trials and at the current state of the art, no data are available on the performance of the BVS in patients presenting with ACS with or without ST-segment elevation (STEMI and NSTEMI). We report for the first time data after implantation of the BVS specifically in patients with ACS. Methods: Unselected consecutive patients presenting with acute coronary syndromes with or without ST-segment elevation (STEMI or NSTEMI) were implanted with second generation BVS. Procedural data and short-term clinical outcomes were prospectively evaluated. Results: A total of 49 patients presenting with ACS (35 NSTEMI and 13 STEMI) were implanted with second generation BVS. Mean age was 59±10 years, male gender in 78% of cases; the majority of lesion were located in left anterior descending coronary artery (LAD 53%, CX 23%, RCA 24%); moderate or severe calcification were observed in 46% of lesions. BVS was successfully implanted in 96% of cases (in 2 cases, 1NSTEMI and 1STEMI, the BVS failed in crossing the lesion). BVS overlap was performed in 12 patents and in 2 cases bifurcation lesions were successfully treated with provisional approach. The mean follow-up period was 73±41 days and no cases of target lesion revascularization, myocardial infarction, cardiac death and scaffold thrombosis were reported. Conclusions: The present report is the first investigating the performance of second generation BVS in patients with acute coronary syndromes. Our data suggest feasibility of implantation of this novel device in patients with NSTEMI or STEMI with a high procedural success rate and excellent short-term clinical outcomes.