Current perspectives on the role of bioresorbable scaffolds in the management of coronary artery disease

Abstract

New-generation drug-eluting stents are recommended as the default option in all clinical conditions and lesion subsets in patients undergoing percutaneous coronary intervention (PCI). On the other hand, despite achieving very good results in the rate of restenosis, permanent delivery of a metallic platform is affected by several drawbacks, such as caging of the vessel, side branch jailing, impairment of vasomotion, and the impossibility of lumen enlargement. Also, the presence of residual foreign material may increase the risk of late and very late stent thrombosis and support the need for long-term dual antiplatelet therapy after PCI. These pending limitations of metallic stents can be addressed by the implantation of bioresorbable scaf-folds (BRSs). At present, there are numerous devices available for preclinical or clinical evaluation. This review discusses the evidence for BRS in the management of patients with coronary artery disease.

Bioreactivity of Stent Material: <i>In Vitro</i> Impact of New Twinning-Induced Plasticity Steel on Platelet Activation

“…Cobalt-chromium (CoCr) has so far been considered to be the backbone of several stent generations [6]. However, the permanent delivery of a metallic implant has been demonstrated to be associated with several drawbacks, including vessel caging, vasomotion impairment, late stent thrombosis, and nonpermissive characteristics for later surgical revascularization [15] [16]. Given that a stent's scaffolding effect must only persist for 6 -12 months, i.e.…”

Direct Absorb bioresorbable scaffold implantation in acute coronary syndrome

“…Outcomes of Absorb implantation vary depending on the centre's and operator's experience, implantation technique, and use of intravascular imaging tools [25]. Standard BVS-specific implantation protocol includes predilatation with a non-compliant balloon up to the size of the RVD, implantation of the Absorb of the same size as the RVD, and high-pressure postdilatation for optimal scaffold apposition, with a non-compliant balloon of the same diameter as the RVD or 0.5 mm larger [26,27]. On the other hand, overexpansion might lead to strut fracture, so the size of the postdilatation balloon should not exceed the scaffold diameter by more than 0.5 mm.…”