Bioresorbable scaffolds compared with everolimus-eluting stents for the treatment of chronic coronary total occlusion: clinical and angiographic results of a matched paired comparison.

OBJECTIVES: Data on bioresorbable vascular scaffolds for recanalization of chronic total occlusions (CTOs) are limited. We compared the bioresorbable scaffold Absorb with everolimus-eluting stents for the treatment of true CTO.

METHODS: After recanalization of CTO, 15 lesions treated with the bioresorbable scaffold Absorb were matched with 15 lesions receiving everolimus-eluting stent (EES) (https://www.clinicaltrials.gov NCT02162082). Match criteria were presence of diabetes mellitus, total device length and maximal device diameter. Angiographic follow-up was scheduled after 9 months and clinical follow-up after 12 months. Dual antiplatelet therapy was administered for 12 months. Quantitative coronary analysis was carried out before and after implantation and at angiographic follow-up. All lesions were predilated. The Absorb scaffolds and drug-eluting stents were carefully placed and postdilatated with high-pressure balloons. Patients received dual antiplatelet therapy for 12 months. The baseline characteristics were similar between both the groups. The mean scaffold length was 81.7±29.1 versus 79.3±27.4 mm for the mean stent length (P=0.82). In-device late lumen loss at the 9-month follow-up was 0.38±0.47 versus 0.46±0.60 mm (P=0.69). The device-oriented composite endpoint was similar in both groups, with 6.7% in the Absorb-group versus 13.3% in the EES group because of target lesion revascularization (P=0.54).

CONCLUSION: In CTOs, the use of a bioresorbable scaffold Absorb after recanalization showed similar 9-month angiographic and 12-month clinical results compared with an EES with 12 months of dual antiplatelet therapy.