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May 1, 2015EuroInterventionOpen Access

When and how to use BRS in bifurcations?

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Key result

Provisional main branch stenting with POT is the recommended default approach for BRS bifurcation lesions.

Why the study?

Does the use of bioresorbable coronary scaffolds (BRS) improve outcomes compared to metallic DES in patients with bifurcation lesions?

Population

Patients with coronary bifurcation lesions

Comparison

Bioresorbable coronary scaffolds (BRS) vs Metallic drug-eluting stents (DES)

Design

Review

Authors

GSGoran StankovićInterventional CardiologyJLJens Flensted LassenInterventional Cardiology

Discussion

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Implication

Supports provisional BRS bifurcation technique with early data; leaves open superiority versus metallic DES.

Structured PICO

Does the use of bioresorbable coronary scaffolds (BRS) improve outcomes compared to metallic DES in patients with bifurcation lesions?

P
Population
Patients with coronary bifurcation lesions
I
Intervention
Bioresorbable coronary scaffolds (BRS)
C
Comparator
Metallic drug-eluting stents (DES)

This review discusses bench testing and early clinical data regarding the potential advantages and inherent limitations of using bioresorbable coronary scaffolds in bifurcation lesions.

Limitations

  • Bulky profile and limited expansion capacity of BRS
  • Length of time for complete resorption (approximately four years)
  • Creation of 'neointimal bridge' on jailed struts
  • Signals for increased early scaffold thrombosis in all-comers registries
  • Lack of randomized trials evaluating BRS in bifurcations with side branches larger than 2 mm

Cite This Study

Stanković et al. (2015) conducted a review in Coronary bifurcation lesions. Bioresorbable coronary scaffolds (BRS) vs. Metallic drug-eluting stents (DES) was evaluated. A provisional strategy with main branch stenting followed by the proximal optimization technique (POT) is the recommended default approach for treating coronary bifurcation lesions with bioresorbable scaffolds.

synapsesocial.com/papers/6aa8a082c419fc5b3cb5c825https://doi.org/10.4244/eijv11sva44

Topics

Coronary artery diseasePercutaneous coronary intervention
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Stent deformation following simulated side-branch dilatation: A comparison of five stent designs1999 · 127 citations
  2. 2Consensus from the 7th European Bifurcation Club meeting2013 · 178 citations
  3. 3Percutaneous coronary intervention for coronary bifurcation disease: consensus from the first 10 years of the European Bifurcation Club meetings2014 · 250 citations
  4. 4Percutaneous coronary intervention with everolimus-eluting bioresorbable vascular scaffolds in routine clinical practice: early and midterm outcomes from the European multicentre GHOST-EU registry2015 · 454 citations