ABSTRACT
Coronary chronic total occlusions (CTOs) remain one of the most challenging scenarios for percutaneous coronary intervention. CTO lesions usually involve long fibrocalcific plaques often treated with a continuous long-segment stenting. Although drug-eluting stents (DESs) have significantly reduced major acute coronary events and second revascularizations, "full metal jacket" stenting of CTOs has major drawbacks. The everolimus-eluting bioarsorbable vascular scaffold (BVS) may be an attractive technology in such kind of lesions. Percutaneous treatment of CTOs frequently ends up with a long stented segment. A BVS-CTO strategy appears even more appealing in young patients, since reabsorption of scaffolds will likely reduce risks for late events and allow future surgical revascularization if needed. Due to the limitation in length of the BVS, overlapping is needed in the vast majority of cases. In an experimental model, overlapping BVSs resulted in delayed strut coverage and higher neo-intimal hyperplasia, which can potentially lead to important clinical consequences.
