Feasibility of everolimus-eluting bioresorbable vascular scaffolds in patients with chronic total occlusion.

Abstract

OBJECTIVE:

This study evaluates the feasibility of percutaneous coronary intervention with bioresorbable vascular scaffolds (BVSs) in chronic total occlusion (CTO) lesions.

BACKGROUND:

Everolimus-eluting BVSs represent a new approach to treating coronary artery disease, but experience with CTO is limited.

METHODS:

Patients with a previously diagnosed CTO who had been treated with BVS were included. Patients with unsuccessful CTO procedures and patients treated with drug-eluting stents were excluded. Difficulty of the CTO procedure was assessed by the J-score.

RESULTS:

A total of 23 patients were included. Mean age was 60.4 ± 9.0 years, 17.4% were female, 91.3% suffered from hypertension and 34.8% from diabetes. Mean J-score was 1.7 ± 1.0. Median procedure time was 70 min (54-85), mean contrast volume was 213.5 mL (±94.2) and median fluoroscopy time was 19.1 min (13.1-30.0). A total of 64 BVSs were implanted with a mean number of 2.8 ± 1.0 BVSs per patient, a mean total BVS length of 64.8 ± 24.2 mm per lesion, and a mean BVS diameter of 3.1 ± 0.2 mm. Neither a scaffold-related dissection nor any other intra-procedural complication occurred. During a follow-up of 108 (79.5-214.5) days one in-scaffold thrombosis was noted 4 days after the CTO procedure due to a lack of dual antiplatelet therapy. No further major adverse cardiac events occurred.

CONCLUSION:

These results suggest that BVS implantation in CTO lesions can be performed with good procedural success and reasonable clinical short-term outcome in highly selected cases.

• Authors: Jens Wiebe, Christoph Liebetrau, Oliver Dörr, Astrid Most, Kay Weipert, Johannes Rixe, Timm Bauer, Helge Möllmann, Albrecht Elsässer, Christian W Hamm, Holger M Nef
• Journal: International journal of cardiology (Int J Cardiol) Vol. 179 Pg. 90-4 (Jan 20 2015) ISSN: 1874-1754 [Electronic] Netherlands
• PMID: 25464422 (Publication Type: Journal Article, Observational Study)
• Copyright: Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Chemical References

• Immunosuppressive Agents
• Everolimus
• Sirolimus

Topics

• Absorbable Implants
• Comorbidity
• Coronary Occlusion (drug therapy)
• Drug-Eluting Stents
• Everolimus
• Feasibility Studies
• Female
• Humans
• Immunosuppressive Agents (administration & dosage)
• Male
• Middle Aged
• Risk Factors
• Sirolimus (administration & dosage, analogs & derivatives)
• Tissue Scaffolds
• Tomography, Optical Coherence
• Treatment Outcome