Bioresorbable vascular scaffolds for percutaneous treatment of chronic total coronary occlusions occlusions : a meta-analysis

Abstract

Background: BRS represent a new approach to treating coronary artery disease. Beneficial properties of BRS regardingthe restoration of vasomotility after resorption make themattractive devices in CTO revascularization. However,experience in this setting is limited.

Methods: We systematically searched Medline, Scholar, and Scopus for reports of at least 9 patients with CTOundergoing BRS implantation. Patients’and procedural characteristics weresummarized. The primary outcome ofinterest was target lesion revascularization (TLR). Pooled estimates were calculated using a random-effectsmeta-analysis. The study protocol was registered in PROSPERO (CRD42017069322).

Results: Thirteen reports for a total of 843 lesions with a median follow-up of 12 months (IQR 6–12) wereincluded in the analysis. At short-term, the summary estimate rate of TLR was 2.6% (95% CI: 1 to 4%, I2=0%,P=0.887)while at mid to long-term it was 3.8% (95% CI: 2 to 6%, I2=0%,P= 0.803). At long-term follow-up (≥12 months), thesummary estimate rate of cardiac death was 1.1% (95% CI: 0 to 2%, I2= 0%, P = 0.887). The summary estimate rates ofscaffold thrombosis and clinical restenosis were respectively 0.9% (95% CI: 0 to 2%, I2=0%,P= 0.919) and 1.8% (95% CI:0to4%,I2=0%,P= 0.448). Finally, the summary estimate rate of target vessel revascularization was 6.6% (95% CI: 0 to11%, I2=0%,P=0.04).

Conclusions: Implantation of BRS in a population with CTO is feasible, although further longer-term outcome studiesare necessary.