Safety and Effectiveness of XXXX -Eluting Stents in Chronic Total Coronary Occlusion Revascularization: Results From the EXPERT CTO Multicenter Trial (Evaluation of the XIENCE Coronary Stent, Performance, and Technique in @entity432 ).

@entity1 @entity6 @entity75 @entity2239 @entity299 @entity432 @entity583 @entity204 @entity715
OBJECTIVES: This study sought to evaluate procedural and clinical outcomes among @entity1 undergoing chronic total occlusion (CTO) percutaneous coronary intervention (PCI) using contemporary methods and @entity2239 -eluting stents (EES). BACKGROUND: Limited studies have detailed the procedural and late-term safety and efficacy of CTO revascularization among multiple centers applying modern techniques and with newer-generation drug-eluting stents. METHODS: Among 20 centers, 250 consecutive @entity1 were enrolled for attempted CTO PCI. Procedural and in-hospital clinical outcomes were examined in addition to the 1-year primary endpoint of @entity204 , @entity583 , and @entity75 revascularization (major adverse @entity299 [MACE]). RESULTS: @entity75 , and procedural characteristics included prior bypass surgery: 9.9%; @entity6 : 40.1%; lesion length: 36.1    18.5 mm; and stent length: 51.7    27.2 mm. Procedural success, defined as guidewire recanalization with no in-hospital MACE, was 96.4%. Success with antegrade-only methods was 97.9% and 86.2% by retrograde/combined methods, respectively. Compared with a pre-specified performance goal derived from 6 prior CTO drug-eluting stent trials (1-year MACE: 24.4%), treatment with EES was associated with significantly lower composite adverse events for both intent-to-treat (18.5%, 1-sided upper confidence interval: 23.4%, p = 0.025) and per-protocol populations (8.2%, 1-sided upper confidence interval: 12.3%, p < 0.0001). @entity75 revascularization at 1 year was 6.3%. Dual antiplatelet therapy adherence was 53.9% at 1 year, yet subacute definite stent @entity715 occurred in only 2 @entity1 (0.9%), and late probable stent @entity715 occurred in 1 @entity1 (0.5%). CONCLUSIONS: In a multicenter registration trial representing contemporary technique and EES, favorable procedural success and late-term clinical outcomes support CTO PCI in a @entity1 population with high lesion complexity. (EXPERT CTO: Evaluation of the XIENCE PRIME LL and XIENCE Nano Everolimus Eluting Coronary Stent Coronary Stents, Performance, and Technique in @entity432 ; NCT01435031).
