Elsevier, American Journal of Cardiology, 6(117), p. 906-917, 2016
DOI: 10.1016/j.amjcard.2015.12.025
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The potential of bioresorbable vascular scaffold (BVS) technology has been demonstrated in first-in man studies with up to 5-years follow-up. This study sought to investigate the 1-year outcomes of the BVS, for the treatment of chronic total occlusions (CTO), using various imaging techniques. Thirty-five true CTO lesions treated with BVS were included in this prospective study. Scaffolds were deployed after mandatory pre-dilatation and IVUS analysis. Optical coherence tomography (OCT) was performed after BVS implantation and at 10-12 months. Multi-slice computed tomography (MSCT) was performed at baseline and at 6-8 months. Mean patient age was 61 ± 10 years. The most frequent vessel treated was the RCA (46%). Lesions were classified as intermediate (49%) or difficult/very difficult (26%) according to the Japanese CTO complexity score. Pre-dilatation was performed in 100% of lesions, using cutting balloons in 71% of these. The total scaffold length implanted per lesion was of 52 ± 23mm. All scaffolds were delivered and deployed successfully. Post-dilatation was undertaken in 63%. By MSCT at 6 months we observed 2 cases of asymptomatic scaffold restenosis, subsequently confirmed by angiography. At 12 months, no scaffold thrombosis or major adverse cardiac events (MACE) were reported. The OCT at follow-up showed that 94% of struts, were well apposed and covered (5% of uncovered struts, 1% of non-apposed struts) and only 0.6% of struts were non-apposed and uncovered. In conclusion, one-year results suggest that BVS for CTO is associated with excellent clinical and imaging outcomes. Accurate percutaneous coronary BVS technique might have enabled these promising results.