BioResorbable Scaffold is not available in South Korea

The objective of this trial is to compare clinical outcomes between imaging-guided and QCA-guided strategy in patients with native coronary artery disease undergoing BRS implantation.

The investigators hypothesized that intravascular imaging-guided BRS implantation is superior to QCA-guided BRS implantation with respect to target lesion failure in patients with native coronary artery disease.

Inclusion Criteria:

• Men or women at least 19 years of age
• Typical chest pain or objective evidence of myocardial ischemia suitable for elective percutaneous coronary intervention
• Native coronary artery lesions with lesion length 50mm and less and reference vessel diameter of 2.5 ~ 3.75mm by quantitative coronary angiography assessment
• The patient or guardian agrees to the study protocol and the schedule of clinical follow-up, and provides informed, written consent, as approved by the appropriate Institutional Review Board/Ethical Committee of the respective clinical site.

Exclusion Criteria:

• Angiographic exclusion criteria: any of the followings

  1. Small vessel: mean reference size < 2.5 mm by quantitative coronary angiography

  2. True bifurcation lesion with a large side branch (reference vessel diameter > 2.3mm) requiring a complex two-stent approach

  3. Left main lesions

  4. Ostial lesions within 3mm of the origin: right coronary artery, left anterior descending, or left circumflex artery

  5. Impaired delivery of the Absorb bio- resorbable vascular scaffold is expected:

     • Extreme angulation (≥90°) proximal to or within the target lesion.
     • Excessive tortuosity (≥two 45° angles) proximal to or within the target lesion.
     • Moderate or heavy calcification proximal to or within the target lesion.

  6. In-stent restenotic lesions

• ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (with 12- 24 hour after symptoms onset)

• Prior percutaneous coronary intervention within the target vessel during the last 12 months.

• Prior percutaneous coronary intervention within the non-target vessel or any peripheral intervention is acceptable if performed anytime >30 days before the index procedure, or between 24 hours and 30 days before the index procedure if successful and uncomplicated.

• Left ventricular ejection fraction (LVEF) < 30%

• Hypersensitivity or contraindication to device material and its degradants (everolimus, poly (L-lactide), poly (DL-lactide), lactide, lactic acid) and cobalt, chromium, nickel, platinum, tungsten, acrylic and fluoro polymers that cannot be adequately pre-medicated.

• Persistent thrombocytopenia (platelet count <100,000/µl)

• Any history of hemorrhagic stroke or intracranial hemorrhage, transient ischemic attack or ischemic stroke within the past 6 months

• A known intolerance to a study drug (aspirin, clopidogrel or ticagrelor)

• Patients requiring long-term oral anticoagulants or cilostazol

• Any surgery requiring general anesthesia or discontinuation of aspirin and/or an Adenosine diphosphate(ADP) antagonist is planned within 12 months after the procedure.

• A diagnosis of cancer (other than superficial squamous or basal cell skin cancer) in the past 3 years or current treatment for the active cancer.

• Any clinically significant abnormality identified at the screening visit, physical examination, laboratory tests, or electrocardiogram which, in the judgment of the Investigator, would preclude safe completion of the study.

• Hepatic disease or biliary tract obstruction, or significant hepatic enzyme elevation (alanine transaminase (ALT) or aspartate transaminase (AST) > 3 times upper limit of normal).

• Life expectancy < 5 years for any non-cardiac or cardiac causes

• Unwillingness or inability to comply with the procedures described in this protocol.

• Patient's pregnant or breast-feeding or child-bearing potential.