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Bioresorbable Scaffold: The Emerging Reality and Future Directions
Yohei Sotomi1, Yoshinobu Onuma1, Carlos Collet1
1From the Department of Cardiology, Academic Medical Center, University of Amsterdam, the Netherlands (Y.S., C.C.); ThoraxCenter, Erasmus Medical Center, Rotterdam, the Netherlands (Y.O., E.T.); Cardialysis, Rotterdam, the Netherlands (Y.O.); CVPath, Institute Inc, Gaithersburg, MD (R.V.); Department of Cardiology (NSK), Houston Methodist DeBakey Heart and Vascular Center, Texas (N.S.K.); and NHLI, Imperial College London, United Kingdom (P.W.S.).
Fully bioresorbable scaffolds offer potential advantages over metallic stents but face challenges like scaffold thrombosis. Ongoing research aims to improve device and implantation techniques for better clinical outcomes in coronary artery disease.
Area of Science:
- Cardiovascular medicine
- Biomaterials science
- Interventional cardiology
Background:
- Drug-eluting stents (DES) demonstrate excellent clinical results but have limitations.
- Permanent metallic stents carry risks including neoatherosclerosis and very late stent thrombosis.
- Fully biodegradable devices were developed to overcome metallic stent limitations.
Purpose of the Study:
- To review current CE-mark approved bioresorbable scaffolds.
- To discuss their characteristics and clinical results.
- To summarize limitations and potential solutions for bioresorbable scaffolds.
Main Methods:
- Review of current literature on bioresorbable scaffolds.
- Analysis of clinical trial and registry data for approved devices.
- Evaluation of device characteristics and implantation procedures.
Main Results:
- Bioresorbable scaffolds aim to provide transient support and inhibit neointimal proliferation.
- Long-term data for some scaffolds (e.g., Absorb) indicate a higher incidence of scaffold thrombosis.
- Improvements in device design and implantation are under investigation to reduce clinical events.
Conclusions:
- Bioresorbable scaffolds present an alternative to metallic stents but require further optimization.
- Addressing scaffold thrombosis and improving long-term safety are critical for widespread adoption.
- Continued research is essential to enhance the performance and safety of these devices.