One-year clinical and computed tomography follow-up after implantation of bioresorbable vascular scaffolds in patients with coronary chronic total occlusions

Abstract

Objectives: To assess the safety and efficacy of everolimus-eluting bioresorbable scaffolds (BRS) in the treatment of chronic total occlusions (CTO) using noninvasive multislice computed tomography (MSCT) angiography at one-year follow-up. Background: Current evidence regarding the safety and efficacy of BRS for the percutaneous treatment of CTO is limited. Methods: Between September 2013 and January 2016, patients who received one or more ABSORB BRSs were included at three centers. MSCT (including quantitative analysis) and clinical follow-up were performed at one year. Results: Forty-one CTO patients were included. Mean age was 6011 years and the majority was male (83%). Average Japanese CTO (J-CTO) score was 0.9 +/- 0.9. Seventy-one BRS were implanted in total with, on average, 1.7 +/- 0.8 scaffolds/patient, and a total length of 43 +/- 20 mm and diameter of 3.1 +/- 0.4 mm. One noncardiac death took place. MSCT angiography was performed in 34 (83%) patients: all scaffolds were patent, except in one patient, in whom a patent target vessel was present on subsequent diagnostic angiography. MSCT quality was sufficient for quantitative analyses in 27 patients (46 scaffolds): median reference versus scaffold minimal lumen diameter and minimal lumen area were measured, and showed a small difference of 0.1 mm (-0.2-0.4) (lumen diameter stenosis = 3.0%) and 0.5 mm(2) (-1.0-2.0) (lumen area stenosis = 4.2%). Conclusions: The low number of events and high patency rate at 1 year are encouraging the further use of the ABSORB scaffold for CTOs with low J-CTO score. Noninvasive MSCT angiography is a valid tool to assess scaffold patency, although its image resolution limits the use for quantitative measurements.