Key result
Newer-generation bioresorbable scaffolds with thinner struts show promising preclinical results, potentially overcoming the target-lesion failure and thrombosis seen with earlier devices.
Why the study?
Following the withdrawal of the Absorb scaffold due to negative mid-term outcomes, engineering refinements have yielded newer-generation bioresorbable scaffolds, prompting an exploration of whether a revival is conceivable.
Newer-generation bioresorbable scaffolds with thinner struts may overcome the safety issues that led to the withdrawal of first-generation devices, potentially reviving their clinical use.
Answers are grounded in this paper and cite their sources.
Absorb withdrawal cautions against BRS adoption in PCI; leaves open whether redesigned scaffolds can succeed.
Bioresorbable scaffolds (BRS) have been introduced in the last decade in percutaneous coronary interventions. Despite several advantages being postulated, the negative results from the mid-term follow-up of the Absorb trials have tempered enthusiasm for these innovative devices. The Absorb scaffold was associated with higher rates of target-lesion failure and scaffold thrombosis when compared to current metallic stents, and for this reason was withdrawn from the market. This failure has to be considered multifactorial, involving technical and technological aspects. Continuous engineering refinements in BRS technology, means newer-generation devices are available in clinical practice, and several more are under preclinical and clinical assessment. Thinner and smaller struts, associated with a faster resorption and reendothelialization process, are at the basis of promising preclinical results for new BRS. In this review we summarize the Absorb scaffold experience and focus on the latest evidence concerning emerging new BRS, to explore if a "BRS revival" is conceivable.
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Buono et al. (2020) conducted a review in Percutaneous coronary interventions. Bioresorbable scaffolds (BRS) vs. Metallic stents was evaluated. Newer-generation bioresorbable scaffolds with thinner struts show promising preclinical results, potentially overcoming the target-lesion failure and thrombosis seen with earlier devices.
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