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Bioresorbable Scaffolds for Coronary Stenosis: When and How Based Upon Current Studies
Alexandre Abizaid1,2,3, J Ribamar Costa4,5
1Instituto Dante Pazzanese de Cardiologia, Av. Dr. Dante Pazzanese, 500 - Vila Mariana, São Paulo, SP, Brazil, CEP 04012-180. aabizaid@uol.com.br.
Current Cardiology Reports
|March 17, 2017
Summary
First-generation bioresorbable scaffolds (BRS) show promise but have a higher thrombosis risk, especially in complex cases. Current indications are limited, but new scaffolds may overcome these issues.
Area of Science:
- Cardiovascular research
- Medical device technology
- Interventional cardiology
Background:
- First-generation bioresorbable scaffolds (BRS), primarily poly-l-lactic acid (PLLA) devices, show comparable efficacy to metallic drug-eluting stents in simpler lesions.
- However, increased device thrombosis has been noted, particularly in off-label applications.
Purpose of the Study:
- To review the limitations of first-generation BRS.
- To identify patient and lesion characteristics where BRS use is currently uncertain or should be avoided.
Main Methods:
- Review of available scientific data, including randomized trials and real-world registries.
- Analysis of device deployment techniques and clinical outcomes.
Main Results:
- First-generation BRS are associated with a trend toward higher acute/subacute thrombosis rates.
- Precise vessel sizing and post-dilation caution are critical for deployment.
- Higher risks observed in small coronary arteries, long lesions, acute coronary syndromes (including STEMI), bifurcations, and ostial lesions.
Conclusions:
- Current indications for first-generation BRS are restricted due to significant drawbacks, notably thrombosis.
- Newer generation scaffolds are under development and may address these limitations.
