This study sought to compare the 2-year outcomes between bioresorbable vascular scaffolds (BVS) and everolimus-eluting metallic drug-eluting stents (EES), since the occurrence of very late thrombosis (thrombosis beyond 1 year after implantation) is an increasing concern in relation to new devices. This meta-analysis was conducted based on 24 studies (BVS: n = 2567 and EES: n = 19,806) reporting the...
1-Year Clinical Outcomes of Everolimus-Eluting Bioresorbable Vascular Scaffolds in Diabetic Patients
Original title: 1-Year Clinical Outcomes of Diabetic Patients Treated With Everolimus-Eluting Bioresorbable Vascular Scaffolds A Pooled Analysis of the ABSORB and the SPIRIT Trials. Reference: Muramatsu T et al. JACC CardiovascInterv. 2014 May;7(5):482-93. This study included ABSORB, ABSORB Extend and SPIRIT patients. A total of 136 diabetic patients and 415 non diabetic receiving everolimus-eluting bioresorbable scaffolds (Absorb) and...
EuroPCR 2021 | FUTURE II: Bioresorbable Scaffolds Reloaded
A new sirolimus-eluting bioresorbable scaffold with far thinner struts resulted non inferior to the Xience as to the end point of angiographic in-segment late loss (LL) powered for noninferiority testing. Even though this is a small study with angiographic end points, it might be the first step towards the return of bioresorbable scaffolds. Read also:...
TCT 2018 | ABSORB IV: Much Life Left for Bioresorbable Scaffolds
Previous studies have documented higher rates of adverse events with bioresorbable scaffolds (ABSORB) compared with metallic drug-eluting stents (DES). However, these studies included lesions smaller than recommended for these scaffolds and a suboptimal implantation technique. The ABSORB IV study, presented by Dr. Stone at TCT 2018 and published simultaneously in The Lancet, randomized patients to polymeric everolimus-eluting scaffold Absorb...
More Bad News on Bioresorbable Scaffolds
A year after the implantation of everolimus-eluting bioresorbable scaffold Absorb 1.1, optical coherence tomography (OCT) scans showed neointima formation covering plaque without significant luminal loss. At 5 years, the device is supposed to disappear completely, potentially thrombogenic plaque components are supposed to be covered by endothelium, and the vasomotor function is supposed to be recovered. However, there...
Absorb IV: Bioresorbable Scaffolds with an Optimized Implantation Technique
Courtesy of the SBHCI. The Absorb IV trial randomized 2604 patients in a 1:1 ratio to receive an Absorb everolimus-eluting bioresorbable scaffold or a Xience stent. With the aim of minimizing the problems observed in previous studies, the Absorb IV protocol excluded small caliber (<2.5 mm) vessels and included mandatory aggressive pre-dilation followed by non-complacent balloon post-dilation. Patients could...
ABSORB II: No Benefits from Scaffolds After Complete Bioresorption
Courtesy of the SBHCI. The ABSORB II study sought to assess the mechanical properties of everolimus-eluting bioresorbable scaffolds, such as the increase in minimal lumen area and the recovery of the vasomotor properties of the treated artery. Last year saw the publishing of negative results for the primary endpoints, registering a higher rate of complications at...
Very Late Thrombosis in Bioresorbable Scaffolds
The presence of a metallic device interrupts normal laminar flow and creates an artery environment that favors thrombosis, leaving the vessel vulnerable to very late thrombosis. Dual antiplatelet therapy, a better implantation technique, and several improvements in new drug-eluting stents (DES) (thinner struts, and higher polymer stability and biocompatibility) have lowered significantly the incidence of...
Are Bioresorbable-Polymer Stents More Thrombogenic than Durable-Polymer Second-Generation Stents?
Courtesy of Dr. Cristian Jesús Rodríguez. Most stents currently used in percutaneous coronary intervention (PCI) are durable-polymer second-generation drug-eluting stents (DP-DES, with everolimus or zotarolimus). However, it has been argued that the persistence of such a polymer after complete drug elution is one of the main factors for a dangerous complication: stent thrombosis (ST). After...
AIDA: bioresorbable scaffold thrombosis still a concern in studies
Courtesy of the SBHCI. This study presented at PCR and simultaneously published by NEJM still challenges the safety of bioresorbable scaffolds. This was a multicenter noninferiority work carried out in the Netherlands, comparing 1:1 everolimus-eluting bioresorbable scaffold ABSORB and permanent-polymer everolimus-eluting stent Xience. The primary endpoint was target-vessel failure (a composite of cardiac...