循環器ジャーナル70巻3号

2022年07月発行

特集 進化するカテーテルインターベンション—適応の広がりとデバイスの革新 Ⅱ章　冠動脈インターベンション

生体吸収性スキャフォールド

著者： 邑井洸太¹ 大塚文之¹

所属機関： ¹国立循環器病研究センター心臓血管内科冠疾患科

ページ範囲：P.379 - P.388

Point
・生体吸収性スキャフォールド（BRS）は，一定期間のみ血管を支え，その後消失するデバイスである．
・Absorb^® BVSは留置後3年以内のデバイス血栓症が多く，製造中止となった．
・超長期的なメリットへの期待は依然として存在し，血栓症リスクの少ない新たなBRSの開発が待たれる．

参考文献

1）Peng X, Qu W, Jia Y, et al : Bioresorbable Scaffolds : Contemporary Status and Future Directions. Front Cardiovasc Med 7 : 589571, 2020

2）Bangalore S, Bezerra HG, Rizik DG, et al : The State of the Absorb Bioresorbable Scaffold : Consensus From an Expert Panel. JACC Cardiovasc Interv 10 : 2349-2359, 2017

3）Stone GW, Abizaid A, Onuma Y, et al : Effect of Technique on Outcomes Following Bioresorbable Vascular Scaffold Implantation : Analysis From the ABSORB Trials. J Am Coll Cardiol 70 : 2863-2874, 2017

4）Karanasos A, Simsek C, Gnanadesigan M, et al : OCT assessment of the long-term vascular healing response 5 years after everolimus-eluting bioresorbable vascular scaffold. J Am Coll Cardiol 64 : 2343-2356, 2014

5）Serruys PW, Ormiston J, van Geuns RJ, et al : A Polylactide Bioresorbable Scaffold Eluting Everolimus for Treatment of Coronary Stenosis : 5-Year Follow-Up. J Am Coll Cardiol 67 : 766-776, 2016

6）Otsuka F, Pacheco E, Perkins LE, et al : Long-term safety of an everolimus-eluting bioresorbable vascular scaffold and the cobalt-chromium XIENCE V stent in a porcine coronary artery model. Circ Cardiovasc Interv 7 : 330-342, 2014

7）Fujino M, Otsuka F, Noguchi T, et al : Fate of late-acquired bioresorbable scaffold malapposition : insights from serial optical coherence tomography. Eur Heart J 41 : 4446, 2020

8）Raber L, Brugaletta S, Yamaji K, et al : Very Late Scaffold Thrombosis : Intracoronary Imaging and Histopathological and Spectroscopic Findings. J Am Coll Cardiol 66 : 1901-1914, 2015

9）Stone GW, Gao R, Kimura T, et al : 1-year outcomes with the Absorb bioresorbable scaffold in patients with coronary artery disease : a patient-level, pooled meta-analysis. Lancet 387 : 1277-1289, 2016

10）Ali ZA, Gao R, Kimura T, et al : Three-Year Outcomes With the Absorb Bioresorbable Scaffold : Individual-Patient-Data Meta-Analysis From the ABSORB Randomized Trials. Circulation 137 : 464-479, 2018

11）Neumann FJ, Sousa-Uva M, Ahlsson A, et al : 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J 40 : 87-165, 2019

12）Stone GW, Kimura T, Gao R, et al : Time-Varying Outcomes With the Absorb Bioresorbable Vascular Scaffold During 5-Year Follow-up : A Systematic Meta-analysis and Individual Patient Data Pooled Study. JAMA Cardiol 4 : 1261-1269, 2019

13）Verheye S, Wlodarczak A, Montorsi P, et al : BIOSOLVE-Ⅳ-registry : Safety and performance of the Magmaris scaffold : 12-month outcomes of the first cohort of 1,075 patients. Catheter Cardiovasc Interv 98 : E1-E8, 2021

14）Campos CM, Muramatsu T, Iqbal J, et al : Bioresorbable drug-eluting magnesium-alloy scaffold for treatment of coronary artery disease. Int J Mol Sci 14 : 24492-24500, 2013

15）Waksman R, Lipinski MJ, Acampado E, et al : Comparison of Acute Thrombogenicity for Metallic and Polymeric Bioabsorbable Scaffolds : Magmaris Versus Absorb in a Porcine Arteriovenous Shunt Model. Circ Cardiovasc Interv 10 : e004762, 2017

16）Song L, Xu B, Chen Y, et al : Thinner Strut Sirolimus-Eluting BRS Versus EES in Patients With Coronary Artery Disease : FUTURE-Ⅱ Trial. JACC Cardiovasc Interv 14 : 1450-1462, 2021