Current status and future perspectives of bioresorbable stents in peripheral arterial disease

Abstract

Experience with the use of bioresorbable stents in PAD is still limited and is investigated only in small studies. The use of bioresorbable stents in PAD appears to be feasible and safe. With current published results, we are unable to fully answer all of the questions about the future use of bioresorbable stents in PAD, and use should be limited to study-related cases in PAD.

Intravascular treatment of long segments of experimental peripheral arteries with multiple, serial, balloon-expandable, resorbable scaffolds

“…Numerous clinical investigators have theorized that bioresorbable vascular scaffolds might represent a favorable paradigm shift in endovascular therapy, notably by offering the advantages of avoiding a chronic foreign body reaction and enhancing adaptive remodeling. 22 , 23 Nevertheless, the initial enthusiasm for this technology has been met by skepticism. 24 In the ESPRIT I [a clinical evaluation of the Abbott vascular ESPRIT BVS (bioresorbable vascular scaffold) system] trial, an everolimus-coated 1:1 mixture of poly- d and l -lactide 6- × 60-mm scaffold was tested in 35 patients and yielded 100% technical success and 94% primary patency at 12 months.…”

A systematic review and meta-analysis of bioresorbable vascular scaffolds for below-the-knee arterial disease

“…63 Furthermore, treatment goals and effects of complications differ between coronary and peripheral artery disease. 64,65 If late scaffold thrombosis or restenosis occurs in peripheral arteries after wound healing has taken place, it is not so harmful, whereas late scaffold thrombosis or restenosis in coronary arteries leads to myocardial infarction and possible death. Extrapolating studies including patients with coronary artery disease to…”

State-of-the-Art Endovascular Therapies for the Femoropopliteal Segment: Are We There Yet?

“…At present, data on in vivo performance of bioresorbable scaffolds are sparse but encouraging in the treatment of short lesions. 125 The ESPIRIT 1 trial (n ¼ 32) evaluated the performance of an everolimus-eluting poly-L-lactide scaffold in external iliac and femoropopliteal segments. Of the treated lesions, 89% were femoropopliteal, with rates of binary restenosis at 1 and 2 years of 12.1% and 16.1% and TLR of 8.8% and 11.8%, respectively.…”

“…At present, data on in vivo performance of bioresorbable scaffolds are sparse but encouraging in the treatment of short lesions. 125 The A Clinical Evaluation of the Abbott Vascular ESPRIT BVS (Bioresorbable Vascular Scaffold) System for the Treatment of Subjects With Symptomatic Claudication From Occlusive Vascular Disease of the Superficial Femoral (SFA) or Common or External Iliac Arteries (ESPIRIT 1) DA trial (n = 32) evaluated the performance of an everolimus-eluting poly-L-lactide scaffold in external iliac and femoropopliteal segments. Of the treated lesions, 89% were femoropopliteal, with rates of binary restenosis at 1 and 2 years of 12.1% and 16.1% and TLR of 8.8% and 11.8%, respectively.…”