Author + information
- Magdalena Lanocha1,
- Maciej Lesiak2,
- Aleksander Araszkiewicz2,
- Andrzej Siniawski3,
- Przemyslaw Mitkowski4,
- Wlodzimierz Skorupski5,
- Marek Grygier6,
- Malgorzata Pyda7,
- Marta Kaluzna-Oleksy8,
- Stanislaw Jankiewicz2,
- Michal Lesiak6,
- Sylwia Iwanczyk6,
- Magdalena Dudek2 and
- Stefan Grajek9
- 1Poznań University of Medical Sciences, Poznan, Poland
- 2Department of Cardiology, Poznan University of Medical Sciences, Poznan, Poland
- 3Ist 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
Preserving patency of side branches(SB) involved into chronic total occlusion(CTO) lesions is still a technical challenge for interventional cardiologist during CTO procedures. The aim of the study was to evaluate the early and long-term clinical outcomes of CTO-bifurcation lesion stenting with everolimus-eluting scaffolds (BVS).
The subanalysis of a prospective, nonrandomized clinical registry of patients with CTO lesion treated with BVS. Consecutive patients with indication for CTO revascularization with involved bifurcation lesion into CTO were enrolled between 2012-2015. Bifurcation lesion was defined and classified according to European Bifurcation Club definition and Medina classification. The main clinical study end point was a device-oriented target lesion failure (TLF).
65 consecutive patients with CTO lesion coexisting with bifurcation lesion (male 77%, mean age 60,2 ±8,6 years) were included. True bifurcation lesion was found in 7 patients (11%). Mean J-CTO score was 1.6 and in 25 (38%) cases were OCT-guided procedure. Based on QCA assessment (Medis Suite XA) the mean side branch (SB) reference diameter was 2.24 ± 0.41 mm, SB diameter stenosis 41.8± 22,3%. A total of 102 BVS were implanted with the average number of 1.6 per patient, and the scaffold length of 43,0 ± 18,9 mm. Provisional T stenting was performed in 63 patients (97%), distal main vessel stenting in 1 (1,5%) and SB ostial stenting was in 1 patient (1,5%). The final kissing was performed in 15 cases (23%) and TIMI III flow was in all the SBs. The procedural success was achieved in 100%. Control angiography and OCT were performed in 46 (71%) patients at a median time 15±9months with following results: 2 cases in-scaffold restenosis (TLR-3%); 6 cases of lesion progression distally to the distal cup of CTO requiring a new stent implantation (TVR-9%) and 2 (3%) cases of coronary aneurysm formation. All side branches involved into previous treated CTO lesion remained open with TIMI III flow during follow up.
Stenting of CTO-bifurcation lesions with bioresorbable everolimus-eluting scaffolds is an interesting and tempting treatment option with excellent early and long-term clinical outcomes.
CORONARY: Stents: Bioresorbable Vascular Scaffolds