Bioresorbable Scaffold Use in Coronary Chronic Total Occlusions: A Long-Term, Single-Center Follow-Up Study

• Published in: Medicina (Kaunas, Lithuania) Vol. 60; no. 8; p. 1233
• Main Authors: Sondore, Dace, Briede, Ieva, Linde, Matiss, Trusinskis, Karlis, Narbute, Inga, Jegere, Sanda, Lismanis, Aigars, Kumsars, Indulis, Grikis, Karlis, Strazdins, Uldis, Erglis, Andrejs
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 30.07.2024; MDPI
• Subjects: Absorbable Implants; Aged; bioresorbable scaffolds; Cardiology; Cardiovascular disease; Chronic Disease; chronic total occlusion; Coronary Angiography - methods; coronary artery disease; Coronary Occlusion - surgery; Coronary vessels; Drug-Eluting Stents; Female; Follow-Up Studies; Heart attacks; Humans; Ischemia; Longitudinal Studies; Magnesium alloys; Male; Medical imaging; Medical prognosis; Middle Aged; Patients; percutaneous coronary intervention; Percutaneous Coronary Intervention - instrumentation; Percutaneous Coronary Intervention - methods; Physiology; Prospective Studies; Survival analysis; Thrombosis; Tissue Scaffolds; Treatment Outcome; Ultrasonic imaging; Ultrasonography, Interventional - methods; Vein & artery diseases; coronary artery disease; percutaneous coronary intervention; chronic total occlusion; bioresorbable scaffolds
• ISSN: 1648-9144; 1010-660X; 1648-9144
• DOI: 10.3390/medicina60081233

Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) is often associated with longer total stent length. Our aim was to evaluate the long-term safety and effectiveness of bioresorbable scaffold (BRS) implantation in CTO to avoid using a full metal jacket. We conducted a single-center prospective longitudinal case study including 34 patients who underwent PCI of CTO with at least one BRS and drug-eluting stent (DES) implantation ( = 27) or BRS-only at the Latvian Centre of Cardiology between 2016 and 2018. Quantitative coronary angiography (QCA) and intravascular ultrasound were performed during the index procedure and long-term follow-up. Of 34 patients with a mean age of 60.6 ± 9.5 years, 76.5% were male. The most common CTO artery was the right coronary artery (73.5%, = 25). The median length of occlusion was 23.0 mm (interquartile range (IQR) = 13.9-32.7), with a total mean BRS/DES length of 49.6 ± 20.4 mm. During the median follow-up of 5.6 years (IQR = 5.0-5.9), the primary endpoint of target vessel re-occlusion occurred in 5.9% ( = 2) of patients. Target lesion revascularization (TLR) was performed in 35.3% ( = 12) of patients, with a mean time to TLR of 62.5 (95% confidence interval (CI), 53.9-71.2) months. Through QCA, there was a statistically significant increase in median residual diameter stenosis (20.1-31.4%, < 0.01) and residual length of stenosis (5.2-7.1%, = 0.04) compared with the index procedure. Our study demonstrates that BRS is a safe and feasible option for PCI of CTO, allowing for the avoidance of long segment stenting and ensuring long-term patency of the coronary artery.