Bioresorbable Vascular Scaffolds: Should We use Them Again?

Abstract

Context: An important development in the percutaneous management of coronary artery disease was the creation of the drug-eluting stent (DES). The DES reduces the high incidence of target lesion revascularization associated with balloon angioplasty and bare metal stents by overcoming vessel recoil and restenosis. Despite these advantages, DES carries a persistent risk of stent-related problems due to the permanent implantation of a foreign body and the limitation of arterial vasomotion. Similar to DES, bioresorbable vascular scaffolds (BRS) are intended to distribute drugs and offer mechanical support before completely degrading over the years. Evidence Acquisition: This study was a review article. The data were acquired from PubMed and Google Scholar. Medical Subject Headings (MeSH) terms were used when available, and only English articles were included in the review. Results: Recent studies have shown that the BRS is not inferior to modern DES clinically, although some clinical results are worrying, particularly the greater rates of scaffold thrombosis. Early studies showed that BRS was superior to DES; nevertheless, larger-scale applications and longer observations revealed serious problems with their use, such as reduced radial strength and a higher risk of thrombosis, which led to a higher rate of serious adverse cardiac events. Conclusions: The position of DES was not directly challenged by additional attention to procedural details and research on the second generation of BRS with innovative features. Bioresorbable vascular scaffolds still have an opportunity to demonstrate their supremacy in standout indicators.