Bioresorbable scaffolds in interventional radiology: Current concepts and future direction

Remarkable progress has been made in the endovascular management of atherosclerotic lesions in recent decades. Despite initial challenges, such as arterial dissection and acute thrombosis, successive technological innovations have led to the development of stents designed to minimize the risk of restenosis and occlusion. Percutaneous transluminal angioplasty, combined with antiplatelet regimens and management of cardiovascular risk factors, is now at the forefront of symptomatic arteriosclerotic lesion treatment. However, a persistent limitation of percutaneous transluminal angioplasty is the permanent implantation of metallic stents. The long-term presence of metallic stents requires prolonged antiplatelet therapy, creates artifacts on imaging, and is associated with late or very late stent failure. All these conditions are linked to significant morbidity and mortality. The purpose of this review was to provide interventional practitioners with a comprehensive overview of the need for bioresorbable stents in interventional radiology practice by briefly reviewing the vascular healing process, and the factors contributing to stent failure, including patient- and stent-related factors, and by exploring the emergence of bioresorbable stents as the next frontier in endovascular therapy. This article illustrates and discusses how bioresorbable scaffolds could transform the landscape of endovascular interventional radiology from head to toe by retracing the major milestones in bioresorbable scaffold development, outlining future technical improvements, and highlighting current clinical evidence and future perspectives.