Original Title: Percutaneous coronary intervention for chronic total occlusion of the coronary artery with implantation of bioresorbable everolimus-eluting scaffolds.  Poznan CTO-Absorb Pilot Registry.

Reference: Maciej Lesiak, et al EuroIntervention 2016;12:e144-e151

Courtesy of Dr. Carlos Fava.

Chronic total occlusion (CTO) is a real challenge and have a success rate of around 80% with trained operators.  Patency have improved with the new second generation stents. However, the benefit of bioresorbable scaffolds (BVS) in this group of patients is still under discussion.

This is a prospective, non-randomized trial, including 40 patients with CTO, undergoing successful recanalization and PCI with BVS. Mean age was 60 years, most of patients were men, and one third were diabetic.

J-CTO score was 1.6 (0-1 in 18, 2 in 13 y >2 in 9), reference diameter was 2.48 ± 0.33 mm and occlusion length was 18.81 ± 11.5 mm. PCI was performed in 2 patients via retrograde and the rest via anterograde approach. Operators implanted 1.6 scaffolds per patient with a total length of 42.4 ± 21.5 mm.

Follow up was 556 days; there was one late subacute occlusion and one restenosis.

In 27 patients there was a control angiography at 329 days and it showed no restenosis or reocclusion.

Conclusion

Chronic total occlusion treated with bioresorbable vascular scaffolds are feasible and have good clinical evolution in the short and midterm.

Editorial Comment

This prospective analyzis shows a very good performance of BVS in one of the most challenging scenarios of our specialty.

It presents as a limitation the fact that it excluded high risk patients, but encourages us to carry on our research in more complex groups and offer the benefit the new device technology offers.

Courtesy of Dr. Carlos Fava. Fundación Favaloro, Buenos Aires, Argentina.

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