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Defining small vessels and bioresorbable vascular scaffold outcomes
Poonam Velagapudi1, J Dawn Abbott2
1Division of Cardiology, Rhode Island Hospital, Brown Medical School, Providence, Rhode Island.
Summary
Bioresorbable vascular scaffolds (BVS) show comparable safety and efficacy to drug-eluting stents (DES) in small vessels. The BVS-SAVE registry indicates BVS are safe for high-risk small vessel lesions, though further trials are needed.
Area of Science:
- Cardiovascular medicine
- Biomaterials science
- Interventional cardiology
Background:
- Bioresorbable vascular scaffolds (BVS) offer a potential alternative to permanent drug-eluting stents (DES).
- Previous concerns existed regarding thrombosis rates for BVS, particularly in small vessels (<2.75 mm).
- The BVS-SAVE registry aimed to evaluate BVS performance in this challenging patient subset.
Discussion:
- The BVS-SAVE registry provides evidence supporting the safety and efficacy of BVS in small vessels.
- This registry addresses a high-risk lesion subset where stent thrombosis has been a concern.
- Findings suggest BVS can be a viable option for specific small vessel interventions.
Key Insights:
- BVS demonstrated non-inferiority compared to second-generation DES.
- The registry data supports the safety and efficacy of BVS in small vessels (<2.75 mm).
- Thrombosis rates in small vessels remain a critical consideration for BVS adoption.
Outlook:
- Further clinical trials are necessary to establish definitive recommendations for BVS in small vessels.
- Future research should evaluate the optimal threshold for minimal reference vessel diameter for BVS use.
- Comparative studies with advanced DES are needed to fully delineate BVS's role in complex small vessel disease.
