Looking into the future with bioresorbable vascular scaffolds

Abstract

Bioresorbable scaffold technology has evolved over the last few years with a number of devices either available or under clinical and preclinical investigation. The absence of a permanent metallic segment in the treated vessel wall has the potential to address some of the issues still encountered with metallic drug-eluting stents despite improvements in stent platform, polymer and drug elution. Here, the authors review currently available bioresorbable scaffolds for coronary artery use, concentrating on both completed and ongoing preclinical and clinical studies, evaluating their use. The authors also discuss the potential advantages as well as challenges that these novel devices may face in routine clinical practice.

Keywords::

• bioresorbable stent
• bioresorbable vascular scaffold
• drug-eluting stent
• stent thrombosis
• target lesion revascularization

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Bioresorbable vascular scaffold technology has expanded rapidly since the introduction of Igaki-Tamai stent more than 10 years ago.

• • A number of devices are currently either being assessed in randomized clinical trials or under development.

• • Emerging evidence suggests that these devices are effective and safe to use at least in the context of clinical trials and at mid-term clinical follow-up, with the added advantage of not leaving a permanent ‘metallic’ trail behind.

• • The absence of a permanent ‘metallic’ trail may reduce the incidence of restenosis, allow a decrease in antiplatelet therapy duration while also maintaining access for future bypass graft surgery, if required. The use of these devices in ‘real-world’ patients will provide more information on these unanswered questions.

• • With further developments in current technology, these devices offer the possibility of advancing current percutaneous coronary intervention practice further.