Less Is More?: Bioresorbable Vascular Scaffold vs Drug-Eluting Metallic Stent: 10-Year Follow-Up.

Area of Science:

• Cardiovascular Medicine
• Biomaterials Science

Background:

• Bioresorbable vascular scaffolds (BVS) were developed for transient mechanical support and vascular function restoration.
• Concerns regarding higher scaffold thrombosis rates with BVS compared to metallic drug-eluting stents (DES) have been raised.
• Very long-term outcomes of BVS require further investigation.

Observation:

• A 71-year-old male with stable angina received both BVS and DES in the same coronary vessel in 2014.
• Follow-up angiography and intravascular optical coherence tomography were performed 10 years post-implantation.
• Both the BVS and DES demonstrated satisfactory outcomes at the 10-year mark.

Findings:

• The 10-year outcome of the BVS was comparable to the DES in the same patient and vessel.
• Successful long-term BVS performance was observed.
• No significant adverse events related to the BVS were reported up to 10 years.

Implications:

• This case highlights the importance of careful patient and lesion selection for BVS implantation.
• Proper sizing and implantation techniques, including predilatation and postdilatation, are critical for successful long-term BVS outcomes.
• BVS may offer a viable alternative to DES when appropriate selection and implantation techniques are employed, potentially leading to restored vascular function.