నైరూప్య

Procedural safety and short-term outcome in asian men treated with magnesium bio-resorbable scaffold

Nicholas Chua Yul Chye, Mohd Kamal Mohd Arshad, Rizmy Najme Khir, Lim Chiao Wen, Johan Rizwal Ismail, Effarezan Abdul Rahman, Hafisyatul Aiza, Khairul Shafiq Ibrahim, Abdul Wahab Undok, Zubin Othman Ibrahim and Sazzli Kasim

Background: Bioresorbable scaffold offer the advantages of reduced long-term complications such as stent fracture, late stent thrombosis and in-stent restenosis as well as the return of normal vasomotor function and late lumen gain with plaque regression. Objective: Identify safety and outcomes of patients undergoing percutaneous coronary intervention (PCI) with magnesium BRS. Materials and methods: This was a prospective, observational single centre study conducted in UiTM Sungai Buloh from 1st November 2016 to 14th February 2017. Results: 7 patients were enrolled. The mean age was 46±9. All patients were male. Ethnicity breakdown showed 5 Malays, 1 Chinese, and 1 Indian. Cardiovascular risk assessment revealed 85.7% diabetes mellitus, 42.9% smokers, 28.6% hypertension and 28.6% dyslipidaemia. Target vessels treated were 6 left anterior descending (LAD) and 1 right coronary artery (RCA). Out of the 7 patients, 28.6% were type A lesions, 42.8% were type B, and 28.5% were type C. Among those lesions, 4 involved LAD-D1 bifurcations, and 2 were total occlusions. The lesions were prepared with semi-compliant balloons in 5 cases and non-compliant balloons in 2 cases. The balloon-to-stent ratios were 1:1 (n=1), 0.92:1 (n=1), 0.85:1 (n=4) and 0.83:1 (n=1). The magnesium BRS diameters used were 3.5 mm (n=4) and 3.0 mm (n=3) with length of 15 mm (n=1), 20 mm (n=4) and 25 mm (n=2). Post-dilatation in one patient was carried out with non-compliant balloon of equal diameter to the stent, while the rest had upsizing with +0.5 mm larger non-compliant balloon. Procedural outcome was 100% successful. At three-month follow-up, there were no symptoms, MACE or TLR. Conclusion: We demonstrated safety and good short-term outcome in the use of magnesium BRS in our cohort, including stenting of total occlusions as well as bifurcation lesions. A larger cohort and longer-term outcome would better delineate the safety and efficacy of this new technology in treating coronary artery disease.