Self-Apposing Stents in Coronary Chronic Total Occlusions: A Pilot Study

This pilot study assessed the 12-month angiographic and clinical outcomes of self-apposing (SA) stents in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Self-apposing (SA) stents may decrease incomplete strut apposition and stent strut coverage that are c...

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Bibliographic Details
Published in:Heart, lung & circulation lung & circulation, 2024-04, Vol.33 (4), p.500-509
Main Authors: Elborae, Ahmed, Hassan, Mohamed, Meguid, Mohammed Abdel, Bakry, Karim, Samir, Ahmad, Brilakis, Emmanouil, Kandil, Hossam, ElGuindy, Ahmed
Format: Article
Language:English
Subjects:
Aged
Chronic Disease
Chronic total occlusion
Coronary Angiography
Coronary Occlusion - diagnosis
Coronary Occlusion - surgery
Coronary Vessels - diagnostic imaging
Coronary Vessels - surgery
Drug-Eluting Stents
Female
Follow-Up Studies
Humans
In-stent restenosis
Late malapposition
Male
Middle Aged
Optical coherence tomography
Percutaneous Coronary Intervention - methods
Pilot Projects
Prosthesis Design
Self-apposing stent
Time Factors
Tomography, Optical Coherence - methods
Treatment Outcome
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Summary:This pilot study assessed the 12-month angiographic and clinical outcomes of self-apposing (SA) stents in patients undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Self-apposing (SA) stents may decrease incomplete strut apposition and stent strut coverage that are common after CTO PCI. We compared 20 patients who underwent CTO PCI using SA drug-eluting stents (DESs) with 20 matched control patients who underwent CTO PCI using balloon-expandable (BE)-DESs. All patients were followed up clinically for 12 months and had coronary angiography with optical coherence tomography at the end of the follow-up period. The primary end points were stent strut malapposition and strut coverage. The secondary end point was composite major adverse cardiovascular events (MACEs) at 12 months. Both groups had high prevalence of diabetes mellitus, and most of the treated lesions were complex, with 62% having a J-CTO score of ≥3. All CTO PCI techniques were allowed for recanalisation, and 75% of the procedures were guided by intravascular ultrasound. At 12 months, the SA-DES group had fewer malapposed struts (0% [interquartile range (IQR) 0%–0%] vs 4.5% [IQR 0%–20%]; p
ISSN:1443-9506
1444-2892
DOI:10.1016/j.hlc.2024.01.014