Key result
BVS linked to ~11% higher risk of 1-year composite clinical events vs contemporary DES.
Why the study?
Bioresorbable vascular scaffolds were developed to address limitations of permanent metallic drug-eluting stents, but their comparative safety and efficacy remained uncertain.
Do bioresorbable vascular scaffolds reduce the 1-year composite clinical endpoint compared with contemporary drug-eluting stents in adult patients with coronary artery disease?
Meta-Analysis (n=25,934)
Yes
Do bioresorbable vascular scaffolds reduce the 1-year composite clinical endpoint compared with contemporary drug-eluting stents in adult patients with coronary artery disease?
Answers are grounded in this paper and cite their sources.
Compared with contemporary metallic drug-eluting stents, bioresorbable vascular scaffolds confer higher short- and long-term risks of device thrombosis, myocardial infarction, and repeat revascularization without providing any mortality benefit, confirming that contemporary DES remain the preferred coronary revascularization strategy.
Background: Bioresorbable vascular scaffolds (BVS) were developed to address some limitations associated with permanent metallic drug-eluting stents (DES), but the comparative safety and efficacy of these scaffolds remain uncertain. Methods: We conducted a systematic review and meta-analysis of randomized and observational studies comparing BVS with contemporary DES in patients with coronary artery disease. The primary outcome was the composite clinical endpoint at 1-year. Secondary outcomes included mortality, myocardial infarction (MI), revascularization, thrombosis, and angiographic measures. Outcomes at 2, 3, and 5 years were analyzed separately. Trial sequential analysis (TSA) was used to assess the robustness of the evidence for the primary outcome. Results: A total of 51 studies (69 reports) were included. At 1 year, BVS was associated with a higher risk of the composite clinical endpoint than DES (risk ratio (RR) 1.11, 95% confidence interval (CI 1.00-1.22)), mainly driven by increased risks of MI, target lesion revascularization, and thrombosis. In contrast, all-cause and cardiac mortality did not differ significantly between groups. TSA showed that although the cumulative Z-curve reached the required information size, the Z-score did not cross the trial sequential monitoring boundary, indicating that the evidence for the primary endpoint remained inconclusive. During mid- and long-term follow-up, BVS remained associated with higher risks of ischemic events and repeat revascularization, without a survival benefit. Angiographic analyses showed greater late lumen loss, smaller minimal lumen diameter, and greater diameter stenosis with BVS. Conclusions: Compared with contemporary DES, BVS appears to confer a higher ischemic risk without a long-term mortality benefit. Contemporary DES remains the preferred revascularization strategy.
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Yu et al. (2026) conducted a meta-analysis in Coronary artery disease (n=25,934). Bioresorbable vascular scaffolds (BVS) vs. Contemporary drug-eluting stents (DES) was evaluated on Composite clinical endpoint at 1 year (prioritizing device-oriented composite endpoint, followed by MACE or patient-oriented composite endpoint) (RR 1.11, 95% CI 1.00-1.22). Bioresorbable vascular scaffolds were associated with a higher 1-year risk of the composite clinical endpoint compared with contemporary drug-eluting stents (RR 1.11, 95% CI 1.00-1.22).
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