Long-term outcomes following bioresorbable vascular scaffolds

Expert Rev Cardiovasc Ther. 2024 Aug;22(8):391-407. doi: 10.1080/14779072.2024.2375340. Epub 2024 Jul 30.

Abstract

Introduction: The higher scaffold thrombosis rates observed with the first-generation bioresorbable scaffolds (BRSs) compared to conventional drug-eluting stents were likely due in part to bioresorbable polymers having insufficient radial strength, necessitating larger strut profiles. Meta-analysis of the long-term outcomes from the first-generation Absorb bioresorbable vascular scaffold (BVS) showed that this period of excess risk ended at 3 years. Therefore, current attention has been focused on improving early outcomes by increasing the scaffold's tensile strength and reducing strut thickness.

Areas covered: This review summaries the lessons learned from the first-generation BRS. It updates the long-term clinical outcomes of trials evaluating the ABSORB BVS and metallic alloy-based BRS. In addition, it reviews the next-generation BRSs manufactured in Asia.

Expert opinion: Critical areas to improve the performance and safety of biodegradable scaffolds include further development in material science, surface modification, delivery systems, and long-term follow-up studies.

Keywords: Drug-eluting stents; bioresorbable scaffold; long term outcomes for bioresorbable scaffold; new generation scaffold; peripheral artery disease.

Publication types

  • Review

MeSH terms

  • Absorbable Implants* / adverse effects
  • Animals
  • Coronary Artery Disease / surgery
  • Coronary Artery Disease / therapy
  • Drug-Eluting Stents / adverse effects
  • Humans
  • Percutaneous Coronary Intervention / adverse effects
  • Percutaneous Coronary Intervention / methods
  • Polymers
  • Prosthesis Design*
  • Tensile Strength
  • Time Factors
  • Tissue Scaffolds* / adverse effects

Substances

  • Polymers