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

Int J Cardiol. 2018 May 1:258:36-41. doi: 10.1016/j.ijcard.2018.01.115. Epub 2018 Jan 31.

Abstract

Background: 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).

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Bioresorbable polymer; Chronic total occlusion; Drug-eluting stents; Percutaneous coronary intervention.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Absorbable Implants / trends*
  • Aged
  • Chronic Disease
  • Coronary Occlusion / diagnostic imaging
  • Coronary Occlusion / surgery*
  • Drug-Eluting Stents / trends*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / methods
  • Percutaneous Coronary Intervention / trends*
  • Polymers / administration & dosage*
  • Registries
  • Sirolimus / administration & dosage*
  • Treatment Outcome

Substances

  • Polymers
  • Sirolimus