Original Title: Scaffold Thrombosis After Percutaneous Coronary Intervention With ABSORB Bioresorbable Vascular Scaffold. A Systematic Review and Meta-Analysis. Reference: Michael J. Lipinski et al. J Am Coll Cardiol Intv. 2016;9(1):12-24.
The authors of this study carried out a systematic review and a meta-analysis to determine the thrombosis risk of the bioresorbable everolimus eluting scaffold ABSORB (Abbott Vascular, Santa Clara, California).
Although PCI with these new devices has great potential, some concern has recently been raised regarding thrombosis risk.
The analysis included 10510 patients (8351 with bioresorbable scaffolds and 2159 with DES) with a median follow up of 6.4 ± 5.1 months. Most patients (59%) underwent this procedure in the context of ACS.
Among those receiving the bioresorbable scaffold, cardiovascular death occurred in 0.6%, AMI in 2.1%, target vessel revascularization in 2% and definite/probable thrombosis in 1.2% (most were subacute thrombosis with 0.57% of all cases).
Meta-analysis showed that patients receiving the bioresorbable scaffold presented a higher risk of AMI (OR: 2.06, CI 95% 1.31 to 3.22; p=0.002) and definite/probable thrombosis (OR: 2.06, CI 95% 1.07 to 3.98; p=0.03) compared to patients receiving drug eluting stents. On the other hand, there was a tendency to higher all-cause mortality with the bioresorbable platform (OR: 0.40, CI 95% 0.15 to 1.06, p=0.06).
Conclusion
Patients receiving PCI with the everolimus eluting bioresorbable scaffold presented a higher risk of AMI and definite/probable thrombosis during follow up comparted to drug eluting stents. Further research with longer follow up is necessary to determine this risk.