Vascular response and healing profile of everolimus-eluting bioresorbable vascular scaffolds for percutaneous treatment of chronic total coronary occlusions: A one-year optical coherence tomography analysis from the GHOST-CTO registry
La Manna A, Miccichè E, Capodanno D et al.

KEYWORDS
Bioresorbable vascular scaffold; Chronic total occlusion; Optical coherence tomography; Qualitative coronary analysis

BACKGROUND - Bioresorbable vascular scaffolds (BVS) have been heralded with potential benefits that are especially desired in long lesions, including chronic total occlusions (CTOs). Procedural feasibility and mid-term outcomes of BVS in CTOs have been reported. However, there is still a paucity of data regarding the vascular and healing response to BVS in CTOs evaluated by optical coherence tomography (OCT).

METHODS - This study included prospectively 21 patients who had a CTO lesion treated with a BVS. Angiography and OCT scan were recorded at either post-implantation and 1-year follow-up. Quantitative coronary angiography and OCT analyses were performed by an independent core laboratory.

RESULTS - The angiographic analysis showed a significant increase in the percentage of in-segment diameter stenosis at 1 year (11.89±9.5% vs. 21.84±11.7%; p=0.002). The OCT analysis showed a trend (p=0.07) towards increased mean scaffold area and significant reductions in mean lumen diameter (3.1±0.36mm vs. 2.85±0.47mm; p=0.0046), mean lumen area (7.8±1.73mm² vs. 6.76±2mm²; p=0.0082) and minimal lumen area (5.26±1.86mm² vs. 3.56±1.52mm²; p<0.0001). Malapposition area and volume decreased from 0.26±0.17mm² to 0.08±0.1mm² (p=0.0003) and from 14.17±12.92mm³ to 3.99±4.46mm³ (p=0.0014), respectively. The rate of uncovered or malapposed struts, measured at the frame level, was 5.29±6.48% at 1 year.

CONCLUSIONS - In a small series of CTO patients treated with BVS implantation, OCT outcomes at 1year displayed an overall favorable vascular response and healing profile.

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