Related Experiment Video
Updated: Jul 16, 2026
Ferromagnetic Bare Metal Stent for Endothelial Cell Capture and Retention
Published on: September 18, 2015
A Comparison of Performance of the Different Generations of Magnesium-Based Bioresorbable Coronary Stents
Jeremy Ang1,2, Liam Marsden Back3,4
1Cardiac Services, Townsville University Hospital, Townsville, QLD 4814, Australia.
Insights
Magnesium-based bioresorbable stents (MgBRS) show improved safety and efficacy across generations. Newer MgBRS, like Freesolve, demonstrate outcomes comparable to drug-eluting stents, reducing complications like scaffold thrombosis.
Area of Science:
- Cardiovascular Medicine
- Biomaterials Science
- Interventional Cardiology
Background:
- Contemporary coronary stents face chronic complications such as in-stent restenosis and stent thrombosis.
- Poly-L-lactic-acid-based bioresorbable stents were withdrawn due to late stent thrombosis risks.
- Magnesium-based bioresorbable stents (MgBRS) offer a promising alternative for coronary interventions.
Purpose of the Study:
- To systematically review and document the safety and efficacy profile of successive generations of MgBRS.
- To assess the progression of MgBRS technology in treating coronary artery disease.
- To compare the performance of different MgBRS generations against established benchmarks.
Main Methods:
- A systematic review of EMBASE, MEDLINE, and Web of Science databases from 2007 to August 2025.
- Inclusion of studies involving percutaneous coronary intervention with MgBRS for coronary artery disease.
- Primary outcomes included cardiac death, scaffold thrombosis, and target vessel failure (TVF) at various time points (≤12, ≤24, ≤36, ≤60 months); secondary outcome was late lumen loss (LLL).
Main Results:
- Four MgBRS generations (AMS-1, DREAMS 1G, Magmaris, Freesolve) were identified across 25 studies.
- Cardiac death and stent thrombosis rates were <1.0% up to 24 months for all generations, with Freesolve achieving 0% at 36 months.
- Significant improvements in TVF and LLL were observed across generations, with Freesolve showing favorable 12-month LLL (0.2 ± 0.4 mm).
Conclusions:
- Each successive generation of MgBRS demonstrated improved safety and efficacy compared to earlier versions.
- The Freesolve generation exhibits performance comparable to contemporary drug-eluting stents.
- Further randomized head-to-head trials are anticipated to solidify the role of advanced MgBRS in clinical practice.
Abstract:
Background: The permanence of contemporary coronary stents is associated with chronic complications, particularly in-stent restenosis and stent thrombosis. Poly-L-lactic-acid-based bioresorbable stents were withdrawn given late stent thrombosis risk. Magnesium-based bioresorbable stents (MgBRS) have emerged as promising alternatives. This study documents the safety and efficacy profile of MgBRS generations. Methods: A systematic review was performed using EMBASE, MEDLINE and Web of Science (2007 to August 2025). Studies include individuals requiring percutaneous coronary intervention for coronary artery disease with MgBRS. Primary outcomes were cardiac death, definite/probable scaffold thrombosis and target vessel failure (TVF), organised into ≤12, ≤24, ≤36 and ≤60 months. The secondary outcome was late lumen loss (LLL). Results: Four MgBRS generations were identified: AMS-1, DREAMS 1G, Magmaris and Freesolve; and 25 studies were included. Cardiac death and stent thrombosis rates were under 1.0% up to 24 months for all, and 0% with Freesolve at 36 months. AMS-1 had the highest TVF rate at 44.4% at 12 months, improving to 3.6% at 36 months in Freesolve. Only Magmaris had 60-month data, showing 3.4% cardiac death, 2.7% stent thrombosis and 16.4% TVF rates. The data suggest improvement in 12-month LLL: DREAMS 1G (0.4 ± 0.3 mm), Magmaris (0.5 ± 1.1 mm) and Freesolve (0.2 ± 0.4 mm). Conclusions: Each successive generation demonstrated improvement in all studied outcomes since the underperformance of AMS-1. The favourable performance of Freesolve is comparable to contemporary drug-eluting stents. Results of randomised head-to-head trials are anticipated.
