The bioresorbable magnesium scaffold (Magmaris)—State of the art: From basic concept to clinical application

Abstract

Since its introduction to clinical practice, coronary artery stent implantation has become a crucial part of the therapy of coronary artery disease (CAD). Despite the undeniable evolution of percutaneous coronary revascularization procedures, drugeluting stent (DES) technology shows some limitations. To overcome these limitations bioresorbable vascular scaffolds (BRS) were designed as a vesselsupporting technology allowing for anatomical and functional restoration of the vessel after the scaffold intended resorption. Various materials have been proposed as the basis of the scaffold backbone. In this narrative review, we present secondgeneration magnesium-alloy bioresorbable scaffold devices (Magmaris; Biotronik). Additionally, we discuss available preclinical and clinical data regarding this new magnesium BRS.

Magnesium bioresorbable scaffold (Magmaris) versus polymer biodegradable ultrathin drug-eluting stent (Ultimaster) in acute coronary syndrome. Mid-term outcomes (2 years)

“…The risk of stent thrombosis and repeat target lesion revascularization after PCI is higher in patients with ACS at enrollment [ 39 , 40 ]. Although initial safety and efficacy trials of first-generation BRS and second-generation metallic BRS (Magmaris) focused primarily on patients with stable coronary artery disease [ 7 , 8 , 29 , 33 ], several factors could theoretically benefit the ACS population. ACS patients are often young, with a long life expectancy and a lower incidence of previous coronary intervention with DES use, which could potentially promote vessel healing after BRS implantation.…”

“…Theoretically, BRS technology enables the temporary healing of local hyperinflation associated with ACS and subsequent anatomic and functional restoration of the vessel after the resorption of the scaffold. The main idea of the BRS concept [ 7 , 8 ] was to provide lumen patency in the early phase, allow vascular healing, and dissolve over time, potentially leading to a reduction of long-term device-related complications. Initial enthusiasm related to the polymer scaffold Absorb (Abbott Vascular, Santa Clara, United States) was restrained after publishing long-term outcomes [ 6 , 9 , 10 ].…”

Magnesium Bioresorbable Scaffold (BRS) Magmaris vs Biodegradable Polymer DES Ultimaster in NSTE-ACS Population—12-Month Clinical Outcome

“…Also, like in our study, no thrombotic safety concerns occurred, despite the highly thrombogenic setting. We can partly attribute a relatively low rate of thrombosis to scaffold backbone features-higher radial strength which reduces time-dependent recoil phenomena and improves the local hemodynamic properties affecting the endothelization period [ 9 , 26 , 27 ]. In addition, magnesium used to scaffold production has got favorable electrochemical properties -compare to other metals used for implants is more electronegative and may repel negatively charged platelets leading to the indirect reduction of potential thrombogenicity [ 27 , 28 ].…”

Two-Year Outcomes for Patients with Non-ST-Elevation Acute Coronary Syndrome Treated with Magmaris and Absorb Bioresorbable Scaffolds in Large-Vessel Lesions

“…Theoretically, the bioresorbable scaffolds (BRSs) have emerged as an alternative to DESs. The basic assumptions of this medical concept focus on providing initial vascular integrity with a delayed complete resorption of a scaffold and subsequent dismission of the prolonged local inflammatory process [3]. However, long-term data of the first generation of BRS-Absorb (Abbott-Vascular, Chicago, IL, USA) suggest less favorable results compared to leading DESs [4][5][6].…”