Coronary Bioresorbable Vascular Scaffold Use in the Treatment of Coronary Artery Disease

Abstract

Bioresorbable vascular scaffolds (BVS) represent a promising novel approach for the treatment of coronary artery disease. BVS promise to address some of the well-known limitations of current drug-eluting stents, while providing a transient scaffolding of the vessel to prevent acute vessel closure/recoil. Drug elution by BVS prevents neointimal proliferation in a similar fashion to drug-eluting stents, and complete bioresorption is associated with late vessel lumen enlargement, plaque regression, and restoration of vasomotion. Based on the pathophysiological reasons and on the results derived from clinical studies, BVS are increasingly being used in clinical practice. The aim of this review is to provide an overview of the current evidence supporting the use of BVS in clinical practice. In particular, we will discuss the randomized controlled trials and registries evaluating the clinical outcome of these devices, with a special focus on their application in patients with acute coronary syndrome and in specific lesion subsets (bifurcations, chronic total occlusions, and in-stent restenosis).

Cardiovascular Applications of Magnesium Alloys

“…The treatment of cardiovascular disease often requires the implantation of prosthetic material [1][2][3][4][5][6][7] or insertion of stents [8][9][10][11][12][13][14]. The ideal cardiovascular prosthesis has good functional properties and the ability to regenerate, without activating the immune system of the host organism [15].…”

Circulation: Cardiovascular Interventions

“…4 Biodegradable stents have been intensely studied and, while they have fulfilled some of their promise, late stent thrombosis remains a limitation. 5 The treatment of chronic total occlusions has made remarkable progress, with success rates rising from 50% to 80%-90% now because of advances in antegrade and retrograde techniques. 5 Perhaps the greatest change has been the growth of structural heart interventions.…”

“…5 The treatment of chronic total occlusions has made remarkable progress, with success rates rising from 50% to 80%-90% now because of advances in antegrade and retrograde techniques. 5 Perhaps the greatest change has been the growth of structural heart interventions. Since transcatheter aortic valve replacement (TAVR) was introduced in 2002, it has grown to an estimated 200 000 procedures worldwide, and it is anticipated to grow to 300 000 by 2020.…”

“The unpredictable ABSORB” – very late stent thrombosis of bioresorbable vascular scaffold

“…They offer a multitude potential advantages over their metallic congeners including full restoration of vessel vasomotion, obviation of the need for prolonged dual antiplatelet therapy (DAPT), prevention of potentially deleterious effects of long-term metals' presence, and possibility of future graft insertion to name a few. [123]…”