Serial invasive imaging follow-up of the first clinical experience with the Magmaris magnesium bioresorbable scaffold

Catheter Cardiovasc Interv. 2020 Feb;95(2):226-231. doi: 10.1002/ccd.28304. Epub 2019 Apr 29.

Abstract

Objectives: To assess the performance of the commercially available Magmaris sirolimus-eluting bioresorbable scaffold (BRS) with invasive imaging at different time points.

Background: Coronary BRS with a magnesium backbone have been recently studied as an alternative to polymeric scaffolds, providing enhanced vessel support and a faster resorption rate. We aimed to assess the performance of the commercially available Magmaris sirolimus-eluting BRS at different time points.

Methods: A prospective, single-center, nonrandomized study was performed at the Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. Six patients with stable de novo coronary artery lesions underwent single-vessel revascularization with the Magmaris sirolimus-eluting BRS. Invasive follow-up including intravascular imaging using optical coherence tomography (OCT) was performed at different time points.

Results: At a median of 8 months (range 4-12 months) target lesion failure occurred in one patient. Angiography revealed a late lumen loss of 0.59 ± 0.39 mm, a percentage diameter stenosis of 39.65 ± 15.81%, and a binary restenosis rate of 33.3%. OCT showed a significant reduction in both minimal lumen area (MLA) and scaffold area at the site of the MLA by 43.44 ± 28.62 and 38.20 ± 25.74%, respectively. A fast and heterogeneous scaffold degradation process was found with a significant reduction of patent struts at 4-5 months.

Conclusions: Our findings show that the latest iteration of magnesium BRS suffers from premature dismantling, resulting in a higher than expected decrease in MLA.

Keywords: Magmaris sirolimus-eluting bioresorbable scaffold; bioresorbable scaffolds; constrictive remodeling; scaffold bioresorption; scaffold collapse; scaffold recoil.

MeSH terms

  • Absorbable Implants*
  • Cardiovascular Agents / administration & dosage*
  • Cardiovascular Agents / adverse effects
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / therapy*
  • Coronary Restenosis / diagnostic imaging
  • Coronary Restenosis / etiology
  • Coronary Vessels / diagnostic imaging*
  • Female
  • Humans
  • Magnesium / chemistry*
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / instrumentation*
  • Predictive Value of Tests
  • Prosthesis Design
  • Sirolimus / administration & dosage*
  • Sirolimus / adverse effects
  • Time Factors
  • Tomography, Optical Coherence*
  • Treatment Outcome

Substances

  • Cardiovascular Agents
  • Magnesium
  • Sirolimus