Key result
Bioresorbable vascular scaffolds are associated with major concerns including lower radial strength and higher risk of thrombosis compared to drug-eluting stents, despite potential niche indications.
Why the study?
Despite safety concerns and unfavorable outcomes with first- and second-generation BVS compared to DES, BVS may still offer superiority in distinctive clinical indications.
Do bioresorbable vascular scaffolds improve outcomes compared to drug-eluting stents in patients undergoing percutaneous coronary interventions?
Do bioresorbable vascular scaffolds improve outcomes compared to drug-eluting stents in patients undergoing percutaneous coronary interventions?
Despite initial promise, bioresorbable vascular scaffolds have demonstrated higher risks of thrombosis and MACE compared to drug-eluting stents, though they may still have niche applications.
BVS may still enable vasomotor restoration after resorption; leaves open whether refined designs overcome early thrombosis risks.
Percutaneous coronary interventions with stent-based restorations of vessel patency have become the gold standard in the treatment of acute coronary states. Bioresorbable vascular scaffolds (BVS) have been designed to combine the efficiency of drug-eluting stents (DES) at the time of implantation and the advantages of a lack of foreign body afterwards. Complete resolution of the scaffold was intended to enable the restoration of vasomotor function and reduce the risk of device thrombosis. While early reports demonstrated superiority of BVS over DES, larger-scale application and longer observation exposed major concerns about their use, including lower radial strength and higher risk of thrombosis resulting in higher rate of major adverse cardiac events. Further focus on procedural details and research on the second generation of BVS with novel properties did not allow to unequivocally challenge position of DES. Nevertheless, BVS still have a chance to present superiority in distinctive indications. This review presents an outlook on the available first and second generation BVS and a summary of results of clinical trials on their use. It discusses explanations for unfavorable outcomes, proposed enhancement techniques and a potential niche for the use of BVS.
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Jeżewski et al. (2019) conducted a review in Acute coronary states. Bioresorbable vascular scaffolds (BVS) vs. Drug-eluting stents (DES) was evaluated. Bioresorbable vascular scaffolds are associated with major concerns including lower radial strength and higher risk of thrombosis compared to drug-eluting stents, despite potential niche indications.
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