Abstracts i1231

Poster Session

P1823

Feasibility of CCTA in assessment of luminal changes and coronary shear stress evo-
lution after implantation of bioresorbable vascular scaffolds
Cernica DR.; Ferent I.; Mester A.; Opincariu D.; Hodas R.; Rodean I.; Chitu M.; Benedek T.; Benedek I.

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University of Medicine, Pharmacy, Science and Technology, Targu Mures, Romania

Funding Acknowledgements: PlaqueImage - financed by the National Authority of Scientific Research and Innovation and the Romanian
Ministry of European Funding
Background: Coronary shear stress (CSS) is a well-established local mechanical factor in atherogenesis, progression and destabilization of
atherosclerotic plaques. Analysis of CSS after coronary stent placement is still lacking of large clinical studies. Purpose: The aim of this
study was to: (1) test the feasibility of Coronary Computed Tomography Angiography (CCTA) for assessment of local hemodynamic and lu-
minal changes after implantation of bioresorbable vascular scaffolds (BVS), and (2) to investigate CSS modifications after BVS implantation.
Methods: We conducted a single center, prospective pilot study on 73 patients with coronary artery disease who underwent elective percuta-
neous coronary intervention (PCI); group 1 (n = 30) – patients with BVS and group 2 (n = 43) – patients with bare metal stent (BMS) implan-
ted. CCTA scanning was performed in all patients prior PCI and at 12 months after PCI. The mean CSS at proximal and at distal part of the
stented segment and at the level of the minimal lumen area (MLA) was calculated at baseline and at 12 months after BVS placement. Re-
sults: CCTA revealed a higher incidence of severe coronary stenosis in group 1 (73%) than in group 2 (30%) (p < 0.0001). Sensibility of
visual evaluation for identification of in-stent restenosis on CCTA was increased in BVS group (94%) than in BMS group (76.19%) (p = 
0.0006), hence the group 1 had lower incidence of non-diagnostic evaluations. Mean CSS at the stented site was significantly lower at 12
months (1.9 +/- 0.68 Pa) that average CSS at baseline (2.87 +/- 3.08 Pa) (p = 0.0001). CSS analysis showed also a significantly decreased
values at proximal level from 3.39 +/- 1.93 Pa at baseline to 1.91 +/- 0.68 Pa at follow up (p < 0.0001), but not a significant decrease at distal
part – 1.3+/-0.72 Pa at baseline and 1.59 +/- 0.65 Pa at 12 months follow up (p = 0.9). Conclusions: CCTA is a feasible technique for assess-
ment of luminal changes following BVS implantation. BVS implantation contribute to the improvement of local hemodynamics by restoring
physiological pattern of coronary flow, as demonstrated by the computational fluid hemodynamics assessment of coronary circulation.