TCT-577 Coronary Liposuction During Primary Percutaneous Coronary Intervention: Evidence by Near-infrared Spectroscopy that Aspiration Reduces Lipid Core Size Prior to Stent Placement David Erlinge 1 , Jan Harnek 2 , Isabel Gonçalves 3 , Matthias Gotberg 4 , James E. Muller 5 , Ryan D. Madder 6 1 Lund University, Lund, Sweden, 2 Inst of Clin Sciences, Lund, Sweden, 3 Lund University, Lund, NA, 4 Lund University, Lund, WI, 5 Infraredx, Inc., Burlington, MA, 6 Frederik Meijer Heart & Vascular Institute, Spectrum Health, Ada, Michigan Background: Intracoronary near-infrared spectroscopy (NIRS) in ST-segment elevation myocardial infarction (STEMI) has demonstrated substantial lipid in STEMI culprit plaques. Thrombus aspiration during PPCI reduces distal embolization and improves reperfusion. This study was performed to examine if thrombectomy reduces the lipid in STEMI culprit plaques. Methods: NIRS-IVUS imaging was performed in STEMI patients at two hospitals in the US and Sweden. After establishment of TIMI 3 flow with an undersized balloon, NIRS was performed, followed by aspiration thrombectomy, followed by repeated NIRS. The culprit lipid content was quantified before and after thrombectomy as the lipid core burden index (LCBI). Aspirates were examined with histology. Results: In 13 STEMI patients (age 64 Æ 10, 69% male), culprit lesions were char- acterized by high lipid content prior to aspiration thrombectomy (LCBI 456Æ145). Thrombectomy resulted in a 35% reduction in culprit lesion lipid content (LCBI pre 456Æ145 vs post 296Æ150, p<0.002). Histological analyzes of aspirates demon- strated thrombus plus lipid, calcium and macrophages, indicating that parts of atherosclerotic plaques had been aspirated. Conclusions: Thrombectomy in STEMI aspirates both thrombus and parts of the culprit atherosclerotic plaque, thereby reducing material which may embolize during stenting. Reduction of lipid content before stenting might contribute to the beneficial effects of thrombectomy and be particularly useful if a large lipid core is present at the culprit site. TCT-578 Vascular Responses at the Edges of the DESolve Novolimus-Eluting Bioresorbable Vascular Scaffold: Serial OCT Observations from the Pivotal, Prospective, Multicenter, DESolve NX Study Daniel Chamie 1 , Stefan Verheye 2 , Joachim Schofer 3 , Jose D. Costa Jr 4 , Ricardo A. Costa 5 , Andrea Abizaid 6 , John Yan 7 , Vinayak Bbhat 8 , Lynn Morrison 9 , Sara Toyloy 8 , Alexandre Abizaid 10 1 Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil, 2 Antwerp Cardiovascular Center, ZNA Middelheim, Antwerp, Belgium, Antwerp, Belgium, 3 Medicare center Prof Mathey, Prof Schofer, Hamburg University Cardiovascular Center, Hamburg, Germany, 4 Instituto Dante Pazzanese de Cardiologia, São Paulo, Brazil, 5 Instituto Dante Pazzanese, Sao Paulo, Sao Paulo, 6 N/A, São Paulo, Brazil, 7 Elixir Medical, Sunnyvale, CA, 8 Elixir Medical Corporation, Sunnyvale, CA, 9 elixir medical corporation, Sunnyvale, CA, 10 Instituto Dante Pazzanese de Cardiologia, São Paulo , São Paulo Background: Lumen loss and significant qualitative plaque changes, particularly increase in fibro-fatty tissue components, have been demonstrated at the edges of metallic DES. Polymeric bioresorbable scaffolds (BRS) have different biological behavior in comparison to metallic stents. In this study, we sought to investigate the vascular responses at the edges of the DESolve PLLA-based novolimus-eluting BRS. Methods: The DESolve NX study enrolled 126 pts treated with the DESolve BRS. Six-month invasive OCT was performed in 40 pts. Serial (baseline and 6 months) OCT images were available for 38 pts. Quantitative and qualitative changes in the 5- mm distal and proximal scaffold edges were examined by OCT at 0.6-mm interval. Results: Overall, 37/38 (97.4%) distal and 34/38 (89.5%) proximal edges had suitable serial OCT images for analysis. No significant changes were observed in lumen areas at both distal (D lumen area: -0.32Æ8.14%; 95% CI: -2.44 to 2.56, p¼0.671) and proximal (D lumen area: -3.03Æ12.12%; 95% CI: -7.21 to 1.50, p¼0.085) edges up to 6 months. At baseline, lipid-rich plaques were seen in 17 (23.9%) of the total 71 analyzed edges [4/37 (5.6%) at distal and 13/34 (38.2%) at proximal edges], and were still evident at 6 months. However, significant reductions in the longitudinal (-0.57Æ0.79 mm; 95% CI: -0.97 to -0.16, p¼0.006) and circumferential (-20.81Æ18.01 degrees; 95% CI: -30.07 to -11.55, p¼0.001) distribution of lipid plaques were observed from baseline to 6 months. Furthermore, a significant increase in mean fibrous cap (FC) (129.41Æ52.97 mm; 95% CI: 102.17 to 156.64, p<0.0001) and minimum FC (88.23Æ57.57 mm; 95% CI: 58.63 to 117.84, p¼0.001) thicknesses were observed up to 6 months. No new lipid plaque developed over time. Conclusions: The DESolve novolimus-eluting BRS showed favorable vascular responses at the adjacent segments outside the scaffolded area. Lumen area was maintained over 6 months, without signs of constrictive remodeling. Signs of lipid plaque stabilization were identified, as translated by reduction in lipid longitudinal and circumferential distribution and increase in the protective FC thickness. No new lipid accumulation was seen up to 6 months TCT-579 Impact of diabetes mellitus on vascular healing after sirolimus eluting stent implantation; an optical coherence tomography study Hoyoun Won 1 , Byeong-Keuk Kim 1 , Dong-Ho Shin 1 , Jung-Sun Kim 2 , Young-Guk Ko 1 , Donghoon Choi 1 , Yang soo Jang 1 , Myeong-Ki Hong 1 1 Cardiology Divison, Severance Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea, Republic of, 2 Yonsei Cardiology Divison, Severance Cardiovascular Center, Yonsei University College of Medicine, Seoul, Korea, Republic of Background: Endothelial progenitor cells play an important role in vascular healing. In diabetes mellitus (DM), circulation number and function of endothelial progenitor cells are reduced. Therefore, we investigated the impact of DM for stent coverage on follow-up optical coherence tomography (OCT) image. Methods: From the OCT registry database, 153 patients (212 lesions, 53 DM patients with 66 lesions) who underwent follow up OCT at 3, 6, 9 or 12 months after sirolimus eluting stent implantation were analyzed. The percentage of uncovered or malapposed struts, intraluminal thrombus and the thickness of neointimal hyperplasia in every 1mm slice of the entire stent length, respectively, was compared between DM and non-DM patients group. Results: The mean percentages of uncovered strut were higher in lesions of DM patients than in that of non-DM patients (29.6 Æ 29.7% vs. 20.9 Æ 11.9% at 3 months, 23.3 Æ 25.9% vs. 20.8 Æ 18.9%, p¼0.731 at 6 months, 14.7 Æ 10.8% vs. 8.4 Æ 11.3% at 9 months and 11.8 Æ17.3% vs. 4.7 Æ 6.4% at 12 months) at every follow up OCT, but the difference was only significant at 9 months follow up (p¼0.026). The mean neointimal hyperplasia thickness, the percentage of malapposed struts and the inci- dence of intracoronary thrombus were not different between two groups at every follow up. Conclusions: This study demonstrated that vascular healing after sirolimus-eluting stent implantation might be delayed in DM patients compared to non-DM patients TCT-580 Impact of Calcified plaque evaluated by Frequency-Domain Optical Coherence Tomography for Side-branch occlusion after Main-branch stent implantation ABSTRACT Yusuke Fujino 1 , Guilherme F. Attizzani 2 , Satoru Mitomo 1 , Sunao Nakamura 3 , Satoko Tahara 4 , Kensuke Takagi 5 1 New Tokyo Hospital, Matsudo, Japan, 2 Cardiovascular Imaging Core Laboratory, Harrington Heart & Vascular Institute, University Hospitals, Cleveland, OH, 3 New Tokyo Hospital, Chiba, Japan, 4 New Tokyo Hospital, Matsudo, Chiba, 5 New-Tokyo Hospital, Japan, Matsudo, Japan Background: Occlusion of SB after MB stent implantation is a potential concern during percutaneous coronary intervention (PCI) of coronary bifurcations as it might require additional procedures (i.e., guidewire crossing, balloon dilatation, and www.jacctctabstracts2013.com TUESDAY, OCTOBER 29, 2013, 3:30 PM–5:30 PM JACC Vol 62/18/Suppl B j October 27–November 1, 2013 j TCT Abstracts/POSTER/Intravascular Imaging and PCI B175 POSTERS