Everolimus-eluting bioresorbable vascular scaffolds for treatment of complex chronic total occlusions

Fam, Jiang Ming; Ojeda, Soledad; Garbo, Roberto; Latib, Azeem; Manna, Alessio La; Vaquerizo, Beatriz; Boukhris, Marouane; Vlachojannis, Georgios J.; Geuns, Robert‐Jan van; Ezhumalai, Babu; Kawamoto, Hiroyuki; Sijde, Jors van der; Felix, Cordula; Pan, Manuel; Serdoz, Roberta; Boccuzzi, Giacomo; Paolis, Marcella De; Sardella, Gennaro; Mancone, Massimo; Tamburino, Corrado; Smits, Pieter C.; Mario, Carlo Di; Seth, Ashok; Serra, Antonio; Colombo, Antonio; Serruys, Patrick W.; Galassi, Alfredo R.; Zijlstra, Felix; Mieghem, Nicolas Van; Diletti, Roberto

doi:10.4244/eij-d-16-00253

Cited by 18 publications

(11 citation statements)

References 34 publications

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“…In this regard, Absorb BVS may have important advantage over metallic stent, as once the scaffold is totally bioresorbed, only vascular tissue remains at the site of previous CTO segment. Although recent reports have raised concerns about the safety of these devices , preliminary data on Absorb BVS in specific context of CTO are reassuring, showing them as a safe and feasible option . The TIGER BVS trial will specifically explore the role of Absorb BVS in recovering normal function and morphology of CTO vessel after its recanalization.…”

Section: Discussionmentioning

confidence: 99%

“…Vasomotor response will be calculated as % change in mean luminal diameter compared to the baseline measurement. At the same time, we will evaluate absolute coronary blood flow from the product of corresponding peak APV values and QCA‐derived coronary artery diameter (1/2 × APV × coronary cross‐sectional area) at baseline and after each adenosine infusion and after NTG bolus .…”

Section: Methodsmentioning

confidence: 99%

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TIcaGrEloR and Absorb bioresorbable vascular scaffold implantation for recovery of vascular function after successful chronic total occlusion recanalization (TIGER‐BVS trial): Rationale and study design

Brugaletta

Gomez‐Lara

Caballero

et al. 2017

Cathet Cardio Intervent

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

TIcaGrEloR and Absorb bioresorbable vascular scaffold implantation for recovery of vascular function after successful chronic total occlusion recanalization (TIGER‐BVS trial): Rationale and study design

Brugaletta

Gomez‐Lara

Caballero

et al. 2017

Cathet Cardio Intervent

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“…The ABSORB stent has a PLLA backbone, strut thickness is about 150 µm, with a bioresorbable coating of poly-D,L-lactic (PDLLA) with a thickness of 7 µm, secreting everolimus with a similar pharmacokinetics to the Xience DES [31,34,35,[45][46][47][48][49]. Due to the presence of ester bonds between the PLLA and PDLLA monomers, degradation occurs by stepwise hydrolysis.…”

Section: Overview Of First and Second Generation Bvsmentioning

confidence: 99%

Bioresorbable Vascular Scaffolds—Dead End or Still a Rough Diamond?

Jeżewski

Kubisa

Eyileten

et al. 2019

JCM

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Percutaneous coronary interventions with stent-based restorations of vessel patency have become the gold standard in the treatment of acute coronary states. Bioresorbable vascular scaffolds (BVS) have been designed to combine the efficiency of drug-eluting stents (DES) at the time of implantation and the advantages of a lack of foreign body afterwards. Complete resolution of the scaffold was intended to enable the restoration of vasomotor function and reduce the risk of device thrombosis. While early reports demonstrated superiority of BVS over DES, larger-scale application and longer observation exposed major concerns about their use, including lower radial strength and higher risk of thrombosis resulting in higher rate of major adverse cardiac events. Further focus on procedural details and research on the second generation of BVS with novel properties did not allow to unequivocally challenge position of DES. Nevertheless, BVS still have a chance to present superiority in distinctive indications. This review presents an outlook on the available first and second generation BVS and a summary of results of clinical trials on their use. It discusses explanations for unfavorable outcomes, proposed enhancement techniques and a potential niche for the use of BVS.

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“…Chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been rapidly evolving. With development of dedicated equipment and growing expertise by several operators and centers, high success rates can be achieved even in highly complex lesions .…”

Section: Introductionmentioning

confidence: 99%

An algorithmic approach for the management of ostial right coronary artery chronic total occlusions

Avran

Boukhris

Drogoul

et al. 2018

Cathet Cardio Intervent

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Treatment of ostial chronic total occlusions (CTOs) of the right coronary artery (RCA) can be challenging. We present an algorithmic approach to the management of such lesions that incorporates all contemporary equipment and techniques. If the RCA ostium can be engaged with a guide catheter then antegrade crossing attempts should be performed. If the antegrade guidewire enters the subintimal space, re-entry into the distal true lumen is performed provided that the antegrade guide catheter provides enough support. If re-entry cannot be achieved, the antegrade wire is left in place to facilitate retrograde recanalization attempts (usually performed using the reverse controlled antegrade and retrograde tracking and dissection-reverse CART-technique). If the RCA ostium cannot be engaged with a guide catheter (for example in flush ostial occlusions) or if the guide catheter does not provide sufficient support, a primary retrograde approach is required, aiming for retrograde guidewire puncture into the aorta, followed by snaring and externalization. Retrograde guidewire puncture can be challenging, requiring use of stiff, highly penetrating guidewires or occasionally use of the Carlino technique. The aforementioned algorithm can facilitate crossing of ostial RCA CTOs.

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Everolimus-eluting bioresorbable vascular scaffolds for treatment of complex chronic total occlusions

Abstract: The present report suggests the feasibility of BVS implantation in complex CTO lesions, given adequate lesion preparation and post-dilatation, with good acute angiographic results and midterm clinical outcomes.

Cited by 18 publications

References 34 publications

TIcaGrEloR and Absorb bioresorbable vascular scaffold implantation for recovery of vascular function after successful chronic total occlusion recanalization (TIGER‐BVS trial): Rationale and study design

TIcaGrEloR and Absorb bioresorbable vascular scaffold implantation for recovery of vascular function after successful chronic total occlusion recanalization (TIGER‐BVS trial): Rationale and study design

Bioresorbable Vascular Scaffolds—Dead End or Still a Rough Diamond?

An algorithmic approach for the management of ostial right coronary artery chronic total occlusions

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