The following is a summary of “Safety and efficacy of everolimus-eluting bioresorbable vascular scaffold for cardiac allograft vasculopathy (CART),” published in the January 2024 issue of Cardiology by Pighi et al.

Despite heart transplantation (HTx) offering hope, long-term survival remains limited by Cardiac allograft vasculopathy (CAV), with interventions like percutaneous coronary intervention (PCI) providing only temporary relief due to high failure rates.

Researchers conducted a retrospective study to assess the safety and efficacy of bioresorbable scaffolds (BRSs) as a novel therapeutic approach for coronary stenoses in CAV.

They conducted a multicenter open-label study (CART) involving patients with advanced CAV undergoing PCI with second-generation ABSORB BRS (Abbott Vascular). The main focus was on the occurrence of 12-month angiographic in-segment scaffold restenosis (ISSR), while secondary objectives encompassed assessing major adverse cardiac events (MACEs) at 12- and 36-month follow-up and the incidence of ISSR at 36 months. Paired intracoronary imaging analysis was performed at baseline and follow-up.

The results showed that (between 2015 and 2017), 35 HTx patients underwent treatment for 44 coronary lesions using 51 BRSs. The primary endpoint occurred in 13.5% of the lesions (5/37), with a cumulative ISSR rate up to 3 years of 16.2% (6/37). Angiographic lumen loss measured 0.40 ± 0.62 mm at 12 months and 0.53 ± 0.57 mm at 36 months. Overall survival rates were 91.4% and 74.3%, with MACEs incidence at 12 and 36 months at 14.2% and 31.4%, respectively. The paired intracoronary imaging analysis revealed a significant increase in vessel external elastic membrane area in the treated segment and some progression of CAV proximally to the BRS.

Investigators concluded that BRSs show promise as a safe and effective PCI option for CAV, offering similar restenosis rates to established drug-eluting stents.

Source: link.springer.com/article/10.1007/s00392-023-02351-9