Original title: Safety and Effectiveness of Everolimus-Eluting Stents in Chronic Total Coronary Occlusion Revascularization Results From the EXPERT CTO (Evaluation of the XIENCE Coronary Stent, Performance, and Technique in Chronic Total Occlusions) Multicenter Trial. Reference: David E. Kandzari et al. J Am Coll Cardiol Intv. 2015, on line before print.

The aim of this study was to evaluate the outcome of recanalization of chronic total occlusions using all contemporary methods and everolimus eluting stents. 250 consecutive patients were registered in 20 centers in which they had planned a recanalization procedure. 

Intra-hospital and after one-year events were recorded, being the primary combined end point of death, MI and TLR. 40% of patients had diabetes history and received a total mean stent length of 51.7 ± 27.2 mm. Procedural success was achieved in 96.4% of the population. The rate of events published in 6 previous works that examined drug-eluting stents and total occlusions was 24.4% per year, which is well above what showed everolimus-eluting stents in this study with 18.5% (p = 0.025) 

The rate of target lesion revascularization at one year was 6.3%. 53.9% of the population reached one year of dual antiplatelet therapy, with a final subacute thrombosis rate of 0.9% (2 patients) and late probable of 0.5% (1 patient).

Conclusion

This multicenter registry exposes currently recanalization of chronic total occlusions with a high success rate and very good long-term results.

Editorial comment

With 40% of diabetes in the population and a length of stents over 50 mm, the 6.3% rate of revascularization is really excellent. Other works published on the subject were, in general, the experience of a center, making it difficult to reproduce the results, but this registry included 20 centers with which it should be assumed that these are the contemporary results of recanalization total occlusions.

SOLACI