Ghione, MatteoMatteoGhioneWykrzykowska, Joanna JJoanna JWykrzykowskaWindecker, StephanStephanWindeckerSerruys, Patrick WPatrick WSerruysBuszman, PawelPawelBuszmanLinke, AxelAxelLinkeSohn, Hae YoungHae YoungSohnCorti, RobertoRobertoCortiAntoni, DiethmarDiethmarAntoniWijns, WilliamWilliamWijnsEstevez-Loureiro, RodrigoRodrigoEstevez-LoureiroMorice, Marie-ClaudeMarie-ClaudeMoriceVan Es, Gerrit-AnneGerrit-AnneVan Esvan Geuns, Robert JanRobert Janvan GeunsJuni, PeterPeterJuniEerdmans, PedroPedroEerdmansDe Vries, TonTonDe VriesKonik, StéphanieStéphanieKonikDi Mario, CarloCarloDi Mario2024-10-242024-10-242016-09-26https://boris-portal.unibe.ch/handle/20.500.12422/145934BACKGROUND Few data are available on long-term follow-up of DES in the treatment of chronic total occlusion (CTO). The LEADERS CTO sub-study compared the long-term results in CTO and non-CTO lesions of a Biolimus A9™-eluting stent (BES) with a sirolimus-eluting stent (SES). METHODS Among 1,707 patients enrolled in the prospective, multi-center, all-comers LEADERS trial, 81 with CTOs were treated with either a BES (n = 45) or a SES (n = 36). The primary endpoint was the occurrence of major adverse cardiac events (MACE): cardiac death, myocardial infarction (MI) and clinically-indicated target vessel revascularization (TVR). RESULTS At 5 years, the rate of MACE was numerically higher in the CTO group than in the non-CTO group (29.6% vs. 23.3%; p = 0.173), with a significant increase in the incidence of target lesion revascularization (TLR) (21.0 vs. 12.6; p = 0.033), but no difference in stent thrombosis (ST). Patients with CTO receiving a BES demonstrated a lower incidence of MACE (22.2% vs. 38.9%; p = 0.147) with a significant reduction in TLR compared to patients receiving a SES (11.1% vs. 33.3%, p = 0.0214) with an incidence similar to that observed in the non-CTO group treated with BES (11.6%). Definite ST at 5 years nearly halved in the BES group (4.4% vs. 8.3%, p = 0.478) with no ST in the BES group after the first year (0% vs. 8.3%, p for interaction = 0.009). CONCLUSIONS The use of a BES showed a reduction in MACE, TVR, TLR, and ST over time in the CTO subset with similar outcome as for non-CTO lesions.enbiodegradable eluting stentchronic total occlusionpercutaneous coronary interventions600 - Technology::610 - Medicine & healtharticle10.7892/boris.896442766585210.5603/CJ.a2016.0071