Author + information
- Maciej Lesiak1,
- Magdalena Lanocha2,
- Andrzej Siniawski3,
- Przemyslaw Mitkowski4,
- Aleksander Araszkiewicz1,
- Wlodzimierz Skorupski5,
- Marek Grygier6,
- Malgorzata Pyda7,
- Michal Lesiak6,
- Marta Kaluzna-Oleksy8,
- Stanislaw Jankiewicz1,
- Sylwia Iwanczyk6,
- Magdalena Dudek1 and
- Stefan Grajek9
- 1Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
- 2Poznań University of Medical Sciences, Poznan, Poland
- 31st Cardiology Clinic in Poznan, Poland, Poznan, Poland
- 4University Hospital of Lord's Transfiguration, Poznań, Poland
- 5University of Medical Sciences Poznan Poland, Poznan, Poland
- 6Poznan University of Medical Sciences, Poznan, Poland
- 7Poznan University of Medical Sciences, Poznan, Poland
- 81st Department of Cardiology Poznan University, Poznan, Poland
- 9Medical University, Poznan, Poland
The data concerning the use of bioresorbable vascular scaffolds (BVS) for coronary chronic total occlusion lesions (CTO) are limited. The aim of the study was to evaluate the early and long-term clinical outcomes of CTO stenting with BVS.
A prospective, nonrandomized clinical pilot registry of patients with CTO lesion located in a major coronary artery, treated with everolimus-eluting scaffolds between January 2013 and September 2016. Patients were eligible if they had symptoms and/or documented reversible myocardial ischemia, with the presence of viable myocardium in territory supplied by the occluded vessel, assessed by cardiac magnetic resonance imaging. Subjects were enrolled after successful recanalization of the target vessel, confirmed intraluminal distal wire position with no major intraprocedural complications. All patients were instructed to remain on DAPT for 12 months post procedure, and then lifelong on aspirin alone.
101 consecutive patients (male 78%, mean age 58.4 ± 8.6) with CTO treated with BVS were enrolled. Localization of CTO: LAD-54%; RCA-39%; LCX-7%. A total of 251 BVS were implanted with the average number of 2.5 per patient, and the scaffold length of 44,3 ± 19,4 mm. Mean J-CTO score was 1.2. Procedural success was achieved in all patients with no device-related complications. Optimal results were confirmed in baseline OCT assessment. At follow-up (median time 25,5 months), there was one cardiac death (1%), one patient experienced subacute and late scaffold thrombosis (ST)(2%). Control angiography was performed at the median time of 15,3 months in 75 patients (70%) with OCT assessment in 47 (43,9%) patients. The control exams showed: 6 cases (6%) in-scaffold restenosis (TLR); 9 (9%) cases of lesion progression distally to the distal cup of CTO requiring a new stent implantation (TVR) and 2 (2%) cases of coronary aneurysm formation.
Stenting of coronary CTO lesions with bioresorbable everolimus-eluting scaffolds is feasible with excellent acute performance. Adequate stenting technique and optimal DAPT is of crucial importance for long-term clinical outcomes.
CORONARY: Bioresorbable Vascular Scaffolds