Outcomes of a novel thin-strut bioresorbable-polymer sirolimus-eluting stent in patients with chronic total occlusions: A multicenter registry

• Published in: International journal of cardiology 2018-05, Vol.258, p.36-41
• Main Authors: Azzalini, Lorenzo, Demir, Ozan M., Gasparini, Gabriele L., Grancini, Luca, La Manna, Alessio, Ojeda, Soledad, Benincasa, Susanna, Bellini, Barbara, Poletti, Enrico, Maccagni, Davide, Soldi, Margherita, Iannetta, Loredana, Trabattoni, Daniela, Gravina, Giacomo, Hidalgo, Francisco, Giannini, Francesco, Pan, Manuel, Tamburino, Corrado, Bartorelli, Antonio L., Reimers, Bernhard, Godino, Cosmo, Carlino, Mauro, Colombo, Antonio
• Format: Article
• Language: English
• Subjects: Bioresorbable polymer; Chronic total occlusion; Drug-eluting stents; Percutaneous coronary intervention
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2018.01.115

We aimed to evaluate the mid-term outcomes of a novel thin-strut bioresorbable-polymer sirolimus-eluting stent (BP-SES) in chronic total occlusion (CTO) percutaneous coronary intervention (PCI), as compared with durable-polymer everolimus-eluting stents (EES). We compiled a multicenter registry of patients undergoing CTO recanalization followed by BP-SES or EES implantation. The primary endpoint was the incidence of target-lesion failure (TLF, a composite of cardiac death, target-vessel myocardial infarction, and target-lesion revascularization) at one year. Propensity score matching (PSM) was used to adjust for case mix. Overall, 413 patients were included (BP-SES n = 242, EES n = 171). PSM resulted in 131 matched pairs, which represented the subject of the main analysis. Antegrade wire escalation was the most successful crossing technique (66% vs. 63%, p = 0.98) in both the BP-SES and EES groups, respectively. Procedural success rates were similar between groups (BP-SES 96% vs. EES 93%, p = 0.24). At one-year follow-up, there were no differences in the primary endpoint of TLF (5.7% vs. 8.3%, p = 0.44), and in cardiac death (0.9% vs. 2.8%, p = 0.32), target-vessel myocardial infarction (0.9% vs 1.9%, p = 0.57), target-lesion revascularization (3.7% vs 3.7%, p = 0.99), or stent thrombosis (0.9% vs. 1.9%, p = 0.57), in BP-SES vs. EES, respectively. Patients undergoing CTO PCI with BP-SES suffer a low rate of TLF at one-year follow-up, which is similar to that of subjects treated with durable-polymer EES. •CTO PCI with BP-SES was associated with low rates of mid-term adverse events.•Patients undergoing CTO PCI with BP-SES suffer a low rate of TLF at one-year.•Outcomes of BP-SES were similar to those of the benchmark EES.•Rates of adverse events were comparable to those observed in non-CTO PCI.