Bioresorbable Scaffolds: Contemporary Status and Future Directions

Area of Science:

• Cardiovascular Medicine
• Biomaterials Science

Background:

• Percutaneous coronary intervention (PCI) is a standard treatment for coronary artery disease.
• Permanent metallic stents used in PCI can impede vascular remodeling and complicate future interventions.
• Bioresorbable scaffolds (BRSs) were developed to provide temporary support and degrade over time, aiming to restore natural vascular function.

Purpose of the Study:

• To review the current status and clinical experiences of bioresorbable scaffolds (BRSs).
• To analyze the prospects and limitations of BRSs in clinical practice.
• To focus on late scaffold thrombosis (ScT) as a primary drawback of BRSs.

Main Methods:

• Literature review of current status and clinical experiences with BRSs.
• Analysis of long-term follow-up data from large-scale trials.
• Examination of the causes and potential solutions for scaffold thrombosis.

Main Results:

• BRSs offer temporary vascular support but carry an increased risk of late scaffold thrombosis (ScT).
• ScT is a major limitation hindering the widespread clinical application of BRSs.
• Understanding the causes of ScT is crucial for device improvement.

Conclusions:

• BRSs have the potential to restore natural vascular physiology but face challenges with long-term safety.
• Addressing the risk of ScT is paramount for the advancement of BRS technology.
• Further improvements are necessary to overcome ScT and enhance the clinical utility of BRSs.