Initial experience with the absorb bioresorbable vascular scaffold below the knee: six-month clinical and imaging outcomes

J Endovasc Ther. 2015 Apr;22(2):226-32. doi: 10.1177/1526602815575256.

Abstract

Purpose: To investigate a new bioresorbable vascular scaffold for the treatment of focal tibial and distal popliteal lesions.

Methods: Tibial and distal popliteal angioplasty was performed in 15 limbs of 14 patients (9 men; median age 82 years) with critical limb ischemia (CLI, n=7) or severe claudication. The 18 lesions (mean length 22.2±14.0 mm) were implanted with 22 everolimus-eluting bioresorbable scaffolds (Absorb). Clinical and ultrasound follow-up was performed at 1, 3, 6, and 12 months to detect restenosis and evaluate safety, midterm restenosis rate, and clinical improvement.

Results: Immediate technical success was 100%, although a single limb suffered 2 scaffold thromboses on the first day; it was salvaged with repeat endovascular intervention. All patients were available for surveillance examinations during a follow-up of 6.1±3.9 months; no patient died. Of the 15 limbs in the analysis, clinical improvement was present in 12 (4 of 7 CLI patients); there was no amputation, bypass surgery, or evidence of binary restenosis on follow-up sonographic examination.

Conclusion: Midterm follow-up for this small pilot sample demonstrates acceptable safety and patency results, together with freedom from all major adverse limb events, using the Absorb bioresorbable vascular scaffold below the knee.

Keywords: absorbable implants; angioplasty; arterial occlusive diseases; bioresorbable vascular scaffold; drug-eluting device; everolimus; ischemia; lower extremity; peripheral artery disease; polymers.

MeSH terms

  • Absorbable Implants*
  • Aged, 80 and over
  • Angioplasty, Balloon / adverse effects
  • Angioplasty, Balloon / instrumentation*
  • Constriction, Pathologic
  • Female
  • Humans
  • Leg / blood supply*
  • Male
  • New South Wales
  • Peripheral Arterial Disease / diagnosis
  • Peripheral Arterial Disease / physiopathology
  • Peripheral Arterial Disease / therapy*
  • Pilot Projects
  • Popliteal Artery* / diagnostic imaging
  • Popliteal Artery* / physiopathology
  • Prosthesis Design
  • Radiography
  • Recurrence
  • Tibial Arteries* / diagnostic imaging
  • Tibial Arteries* / physiopathology
  • Time Factors
  • Treatment Outcome
  • Ultrasonography, Doppler, Color
  • Vascular Patency