Background: Copper wire stents may provoke gradual intra-luminal occlusion through inflammatory reactions. Levo-poly lactic acid (L-PLA), a bioabsorbable polymer, promotes in-vivo angiogenesis in both mouse and rabbit models and may be utilized to induce CTO in large animals. Objective: We investigated the feasibility and reliability of copper wire stents and L-PLA as a means of CTO induction in a porcine model. Methods: In 20 female swine (25-30 kg), copper wire stents were crimped on a 3.0 mm angioplasty balloon and inserted into the mid-left anterior descending coronary artery (LAD) with 1.1: 1 stent: artery ratio. In another group of 20 female swine, L-PLA was wrapped on a guidewire and pushed into the distal LAD with a 3.0 mm balloon catheter to induce embolization. Five weeks later, all pigs were euthanized after follow-up coronary angiography and the arteries were examined histologically. Results: Of 20 pigs which underwent copper stent implantation, 13 died of stent thrombosis (acute: 7, subacute: 6). Total occlusion was observed in 3 and near-total occlusion in 4. Histological studies revealed organized thrombus with fibrosis, calcification, and neovascular channels in pigs with total occlusion. The density of fibrosis was greater at the proximal and distal ends of the occlusive lesions and softer, organizing thrombus was observed in the middle, similar to CTO in humans. Of 20 pigs which underwent L-PLA embolization, 6 suffered death associated with acute myocardial infarction during the procedure or shortly after the experiment. Near total or total occlusion was achieved in 7 and histologic analysis showed, as in the copper stent-induced CTO, organized thrombus with fibrosis. Conclusion: In a porcine model, CTO was reliably induced by copper stents and L-PLA. These models may be useful in treatment of CTO, by providing an opportunity for testing novel coronary interventional devices.