Durable polymer versus bioabsorbable polymer drug eluting stents in right coronary artery chronic total occlusions: Eighteen months (median) results of a single-center experience

Abstract

Objective: There are a few data regarding the long-term clinical outcomes of durable polymer (DP) drug-eluting stents (DES) versus bio absorbable polymer (BP) drug-eluting stents treatment in patients with right coronary artery (RCA) chronic total occlusion (CTO). The aim of this study was to compare the clinical outcomes of these stents according to their polymer-based difference. Methods: Between June 2013 and August 2016, 66 RCA CTO patients enrolled in the study. Fortyseven patients with successful CTO recanalization of RCA via ante grade or retrograde approach using either DP (n=25) and BP (n=22) were scheduled for 6, 12, and 18 months clinical follow-up. Primary clinical outcomes were cardiac death and major adverse cardiac events (MACE). Results: RCA CTO success rate was 71%. There was no difference in Japanese-CTO (JCTO) scores between two groups. Total stent length was longer in BP group, and it was statistically significant (p=0.015). The incidence of cardiac death was not significant between the two groups. After propensity score matching, TVR rates were 12.0% for DP group and 9.1% for BP group at the end of the 18th month (hazard ratio [HR]=0.815; 95% confidence interval [CI]=0.123–5.418; p=0.832) and composite MACE rates were 16.0% for DP group and 15.0% for BP group (hazard ratio [HR]=0.926; 95% confidence interval [CI]=0.182–4.718; p=0.927). Conclusion: This study shows that the efficacy of BP-DES is comparable to that second-generation DP-DES treatment for RCA CTO over 18-month follow-up.