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Bioresorbable vascular scaffolds-what does the future bring?

Jacek Bil1, Robert J Gil2

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Bioresorbable vascular scaffolds (BVS) offer a transient alternative to traditional stents, restoring vessel function. While safe and effective for coronary artery disease, concerns about thrombosis and long-term functionality persist.

Keywords:
AbsorbDEsolveDREAM 2Ghybrid approach

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Area of Science:

  • Cardiovascular Medicine
  • Biomaterials Science
  • Interventional Cardiology

Background:

  • Bioresorbable vascular scaffolds (BVS) provide a temporary solution for coronary artery disease, aiming to restore natural vessel function.
  • The first-generation Absorb BVS (everolimus-eluting poly-L-lactide) has demonstrated safety and efficacy in treating symptomatic coronary artery disease.
  • Recent FDA expert panel review supports Absorb BVS approval, balancing risks and benefits.

Discussion:

  • Concerns remain regarding the long-term vessel functionality and potential for stent thrombosis with BVS.
  • Absorb BVS is utilized off-label in complex cases like acute coronary syndromes, in-stent restenosis, bifurcations, left main stenting, and chronic total occlusions.
  • The transient nature of BVS allows for normal vasomotor tone, positive remodeling, reduced inflammation, and future interventions.

Key Insights:

  • Absorb BVS is proven safe and effective for symptomatic coronary artery disease.
  • Off-label use in complex scenarios shows successful application of BVS.
  • BVS technology facilitates vessel restoration and future treatment options.

Outlook:

  • Ongoing development of next-generation BVS, including DEsolve and DREAM 2G, promises further advancements.
  • Continued research is needed to address long-term outcomes and thrombosis concerns.
  • BVS technology represents a significant shift towards transient medical device solutions.