Three-year outcomes of bioresorbable vascular scaffolds versus second-generation drug-eluting stents

Ke, Junsong; Zhang, Hongyu; Huang, Jun; Lv, Ping; Chen, Yun; Xu, Kai; Yang, Wenxue; Tu, Bangyan

doi:10.1097/md.0000000000021554

Cited by 5 publications

(4 citation statements)

References 31 publications

(37 reference statements)

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“…We did not find significant differences in cardiovascular outcomes between DES and BVS at 7, 30, and 365 days despite the fact that BVS patients were less morbid. Former and recent RTCs and meta-analyses have shown worse or equal mid or long term outcomes of BVS compared to 2nd generation DES, especially if implanted in the context of an AMI [25][26][27][28][29][30][31][32]. The rate of early scaffold/stent thrombosis in our study (BVS 1.5% vs. DES 0.8%) was comparable to that seen in other published reports [27,30,33].…”

Section: Discussionsupporting

confidence: 79%

Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial

Hlinomaz

Motovska

Knot

et al. 2021

JCM

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Drug-eluting stents (DES) are the recommended stents for primary percutaneous coronary intervention (PCI). This study aimed to determine why interventional cardiologists used non-DES and how it influenced patient prognoses. The efficacy and safety outcomes of the different stents were also compared in patients treated with either prasugrel or ticagrelor. Of the PRAGUE-18 study patients, 749 (67.4%) were treated with DES, 296 (26.6%) with bare-metal stents (BMS), and 66 (5.9%) with bioabsorbable vascular scaffold/stents (BVS) between 2013 and 2016. Cardiogenic shock at presentation, left main coronary artery disease, especially as the culprit lesion, and right coronary artery stenosis were the reasons for selecting a BMS. The incidence of the primary composite net-clinical endpoint (EP) (death, nonfatal myocardial infarction, stroke, serious bleeding, or revascularization) at seven days was 2.5% vs. 6.3% and 3.0% in the DES, vs. with BMS and BVS, respectively (HR 2.7; 95% CI 1.419–5.15, p = 0.002 for BMS vs. DES and 1.25 (0.29–5.39) p = 0.76 for BVS vs. DES). Patients with BMS were at higher risk of death at 30 days (HR 2.20; 95% CI 1.01–4.76; for BMS vs. DES, p = 0.045) and at one year (HR 2.1; 95% CI 1.19–3.69; p = 0.01); they also had a higher composite of cardiac death, reinfarction, and stroke (HR 1.66; 95% CI 1.0–2.74; p = 0.047) at one year. BMS were associated with a significantly higher rate of primary EP whether treated with prasugrel or ticagrelor. In conclusion, patients with the highest initial risk profile were preferably treated with BMS over BVS. BMS were associated with a significantly higher rate of cardiovascular events whether treated with prasugrel or ticagrelor.

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Section: Discussionsupporting

confidence: 79%

Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial

Hlinomaz

Motovska

Knot

et al. 2021

JCM

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“…In addition, although there is no significant difference between the groups in the risk of death, the likelihood of clinical complications such as MI and ischemia is higher in BVS than in DES. It should be noted that these results pertain to the first 3 years of the follow-up and might also include acute thrombosis and complications, but no significant difference was observed between these two stents in the 3-to 5-year follow-ups of stenting [27].…”

Section: Discussionmentioning

confidence: 75%

Do Bioresorbable Vascular Scaffold Stents Reduce Very Late Stent Thrombosis? A Systematic Review

Sharifkazemi

Zafar

Sharif

et al. 2022

SN Compr. Clin. Med.

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Given the complications caused by stents, especially acute thrombosis, and the late and very late stent thrombosis (VLST) following percutaneous intervention (PCI) in patients, bioresorbable vascular scaffolds (BRSs) have been designed in recent years, so that their absorbance over 3 years can help eliminate the complications of non-absorbable scaffolds in the coronary arteries. Nevertheless, some studies have demonstrated their ineffectiveness or even the increased incidence of short-term and late thrombosis compared to drug-eluting stents (DESs). Studies including cohorts and registry studies as well as clinical trials have been conducted to compare these two types of stents in terms of the incidence of VLST over a period of more than 1 year. The present systematic review study investigates randomized clinical trials conducted over the last 10 years to compare the incidence rates of VLST as a result of BRSs versus DESs. A total of 11 articles were found that had investigated VLST in randomized clinical trials, and the results of two of the articles showed an increase in these complications with BRS. Therefore, until further studies are conducted and more acceptable results are obtained, we recommend that these types of stents only be used in cases where they are required according to the standards.

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“…These distinctions contributed significantly to the reduced rate of target-lesion revascularization and scaffold thrombosis in comparison with Absorb. The fact that 95% of the magnesium in Magmaris was reabsorbed after 12 months ( 12) is an advantage over Absorb, which required dual therapy for up to 3 years (13).…”

Section: Discussionmentioning

confidence: 99%

Mid-term safe and effective profile of the Magmaris scaffold in percutaneous coronary intervention: a prospective, single-center study

Truong

Tran

Nguyen

et al. 2023

Front. Cardiovasc. Med.

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IntroductionSignificant advances have been made in the diagnosis and treatment of coronary artery disease over the years. New generations of scaffolds containing novel material and eluting drug have produced one of the most significant advancements in coronary intervention. The newest generation would be Magmaris with a magnesium frame and a sirolimus cover.MethodsFrom July 2018 to August 2020, 58 patients treated with Magmaris at the University Medical Center Ho Chi Minh City were enrolled in this study.ResultsA total of 60 lesions were stented, 60.3% of which were left anterior descending (LAD) lesions. There was no in-hospital event. Within 1 year after discharge, we noted one myocardial infarction event that required target-lesion revascularization, one stroke event, one non-target-lesion revascularization patient, two target-vessel revascularization patients, and one in-stent thrombosis. Among them, one myocardial infarction occurrence, one non-target-lesion revascularization, and one in-stent thrombosis event were recorded within the first 30 days after discharge.ConclusionIn conclusion, the Magmaris scaffold is a safe and effective option for structural procedures performed with imaging device support, particularly intravascular ultrasound.

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Three-year outcomes of bioresorbable vascular scaffolds versus second-generation drug-eluting stents

Abstract: Supplemental Digital Content is available in the text

Cited by 5 publications

References 31 publications

Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial

Stent Selection for Primary Angioplasty and Outcomes in the Era of Potent Antiplatelets. Data from the Multicenter Randomized Prague-18 Trial

Do Bioresorbable Vascular Scaffold Stents Reduce Very Late Stent Thrombosis? A Systematic Review

Mid-term safe and effective profile of the Magmaris scaffold in percutaneous coronary intervention: a prospective, single-center study

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