title: Bioresorbable Vascular Scaffolds for the Treatment of Chronic Total Occlusions: An International Multicenter Registry.
abstract: There are only limited studies reporting clinical outcomes after bioresorbable vascular scaffold (BVS; Absorb; Abbott Vascular, Santa Clara, CA) implantation for coronary chronic total occlusions (CTO). The aim of this study was to evaluate the real-world feasibility and safety of BVS implantation for the treatment of CTO.
  
  
  
  We retrospectively evaluated CTO cases treated with BVS from a multicenter registry. The primary end point was target lesion failure defined as a composite of cardiac death, target vessel myocardial infarction, and clinically driven target lesion revascularization. From September 2012 to November 2015, 65 patients with CTO were successfully treated with BVS. The mean age of patients was 60.8±11.0 years; 89.2% were male and 40.0% diabetic. The mean ejection fraction was 57.7±10.8%. The mean reference vessel diameter and CTO lesion length were 3.0±0.4 and 20.2±3.0 mm, respectively. The mean number of BVS deployed per patient was 1.8±0.7, of which mean diameter and total length were 3.0±0.4 and 47.6±19.9 mm, respectively. Postdilatation with noncompliant balloons (mean diameter 3.3±0.3 mm) was performed at high pressures (18.6±5.3 atm) in all cases. Intravascular ultrasound (n=34) or optical coherence tomography (n=31) was performed in all cases. During the follow-up period (median: 453 days, 25th and 75th percentiles: 230 and 703), there were no occurrences of target lesion failure or scaffold thrombosis.
  
  
  
  BVS implantation for the treatment of CTO seems feasible and safe. Appropriate lesion preparation, high-pressure postdilatation, and the use of intravascular imaging are recommended to obtain the best possible final result.
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.).
authors.forename: Satoru
authors.initials: S
authors.lastname: Mitomo
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.).
authors.forename: Toru
authors.initials: T
authors.lastname: Naganuma
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.).
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Fujino
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.).
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawamoto
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.).
authors.forename: Sandeep
authors.initials: S
authors.lastname: Basavarajaiah
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.).
authors.forename: Michael
authors.initials: M
authors.lastname: Pitt
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.).
authors.forename: Wei-Hsian
authors.initials: WH
authors.lastname: Yin
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.).
authors.forename: Damras
authors.initials: D
authors.lastname: Tresukosol
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.).
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.affiliation: From the Department of Cardiology, New Tokyo Hospital, Chiba, Japan (S.M., T.N., Y.F., H.K., S.N.); Department of Interventional Cardiology, Heart of England NHS Trust, Birmingham, United Kingdom (S.B., M.P.); Division of Cardiology, Cheng Hsin Geneal Hospital, Taipei, Taiwan (W.-H.Y.); Division of Cardiology, Siriraj Hospital, Bangkok, Thailand (D.T.); Interventional Cardiology Unit, EMO-GVM Centro Cuore Columbus, Milan, Italy (H.K., A.C.); and Interventional Cardiology Unit, San Raffaele Scientific Institute, Milan, Italy (H.K., A.C.). boss0606@pluto.plala.or.jp.
authors.forename: Sunao
authors.initials: S
authors.lastname: Nakamura
mesh_terms: D020341:Absorbable Implants; D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D001208:Asia; D002908:Chronic Disease; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D005060:Europe; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011474:Prosthesis Design; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
keywords: bioresorbable vascular scaffolds; chronic total occlusion; intravascular imaging; lesion preparation; postdilatation