Retrospective Analysis Evaluates Bioresorbable Vascular Scaffolds to Treat CTOs
January 9, 2017—Bioresorbable vascular scaffolds (BVS) are a feasible and safe treatment of chronic total occlusions (CTO), concluded Satoru Mitomo, MD, et al in a study published online ahead of print in Circulation: Cardiovascular Interventions. The investigators advised that appropriate lesion preparation, high-pressure postdilatation, and the use of intravascular imaging are recommended to obtain the best possible final result.
The background of the study is that there are only limited studies reporting clinical outcomes after BVS (Absorb; Abbott Vascular) implantation for coronary CTO. The investigators sought to evaluate the real-world feasibility and safety of BVS implantation for the treatment of CTO.
As summarized in the study, the investigators analyzed data from an international multicenter registry to evaluate CTO treatment with BVS. The primary endpoint was target lesion failure defined as a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization.
From September 2012 to November 2015, 65 patients with CTO were successfully treated with BVS. The mean age of patients was 60.8 ± 11.0 years, 89.2% were men, and 40% were diabetic. The mean ejection fraction was 57.7 ± 10.8%. The mean reference vessel diameter and CTO lesion length were 3.0 ± 0.4 and 20.2 ± 3.0 mm, respectively. The mean number of BVS deployed per patient was 1.8 ± 0.7, of which mean diameter and total length were 3.0 ± 0.4 and 47.6 ± 19.9 mm, respectively.
Postdilatation with noncompliant balloons (mean diameter, 3.3 ± 0.3 mm) was performed at high pressures (18.6 ± 5.3 atm) in all cases. Intravascular ultrasound (n = 34) or optical coherence tomography (n = 31) was performed in all cases. During the follow-up period (median: 453 days; 25th and 75th percentiles: 230 and 703), there were no occurrences of target lesion failure or scaffold thrombosis, reported the investigators in Circulation: Cardiovascular Interventions.