Contemporary practice and technical aspects in coronary intervention with bioresorbable scaffolds: a European perspective

Abstract

Consensus criteria for patient and lesion selection, BVS implantation and optimisation, use of intravascular imaging guidance, approach to multiple patient and lesion scenarios, and management of complications, were identified.

Impact of postdilatation on performance of bioresorbable vascular scaffolds in patients with acute coronary syndrome compared with everolimus-eluting stents: A propensity score-matched analysis from a multicenter “real-world” registry

“…Metallic stents have a stable structure that is able to provide reliable and compliant expansion of the struts without the risk of disruption; however, BRS with polymeric materials has raised concerns www.cardiologyjournal.org regarding over-expansion, disruption, and the effect of postdilatation following its implantation [27,33]. For the full expansion of BRS, a recent practical review has recommended that postdilatation should use short noncompliant balloons of no more than 0.5 mm larger than the nominal scaffold size, although clear and supporting data are not available [25]. The maximum recommended scaffold expansion is no more than 0.5 mm larger than the nominal scaffold size, which should be followed during the procedure to prevent strut fracture [25].…”

“…For the full expansion of BRS, a recent practical review has recommended that postdilatation should use short noncompliant balloons of no more than 0.5 mm larger than the nominal scaffold size, although clear and supporting data are not available [25]. The maximum recommended scaffold expansion is no more than 0.5 mm larger than the nominal scaffold size, which should be followed during the procedure to prevent strut fracture [25]. In the present study, the mean implantation length was longer in BRS patients as compared to EES patients after matching.…”

“…Prospective studies demonstrated BRS safety and efficacy on selected patients [10][11][12], but some studies have reported increased ST rates [13][14][15][16][17][18][19]. However, data on a large sample of ACS patients are still lacking [15,17,[20][21][22][23][24], and only few studies have evaluated the impact of lesion preparation and postdilatation of BRS [25][26][27]. The aim of the present study was to compare the safety and efficacy of BRS with those of EES in patients with ACS and to investigate the potential role of BRS postdilatation on outcome.…”

Effectiveness and safety of the ABSORB bioresorbable vascular scaffold for the treatment of coronary artery disease: systematic review and meta-analysis of randomized clinical trials

“…In the last years, a European expert consensus (GHOST-EU registry) has proposed a specific protocol to be followed for the correct apposition of scaffolds, the so called "PSP technique" (27). This technique consists in preparation of the lesion, with Predilatation, accurate vessel Sizing (28,29), and mandatory post-dilatation (PSP) (30).…”

Is it possible to further improve clinical results with coronary bifurcation stenting, or what is more important — the technique or the stent?

“…is probably, "the simplest for the lesion technique with the best available drug-eluting stent, keeping all side branches opened with normal flow". There is still a belief that we can improve results of percutaneous treatment for coronary bifurcations with new devices; however, the bioresorbable vascular scaffolds (BVS) still cannot be recommended for routine use [50]. Their wider application is still prevented from technology issues in comparison with third-generation DESs.…”