Bioresorbable Vascular Scaffolds in Coronary Artery Disease: Weighing the Evidence and Next Steps
Authors: Seth S. Martin, Rani K. Hasan
Journal: Annals of Internal Medicine (2016)

Editorials7 June 2016Bioresorbable Vascular Scaffolds in Coronary Artery Disease: Weighing the Evidence and Next StepsSeth S. Martin, MD, MHS and Rani K. Hasan, MD, MHSSeth S. Martin, MD, MHSFrom Johns Hopkins University School of Medicine, Baltimore, Maryland.Search for more papers by this author and Rani K. Hasan, MD, MHSFrom Johns Hopkins University School of Medicine, Baltimore, Maryland.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M16-0754 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail A bioresorbable vascular scaffold (BVS) that provides the support necessary for healing after angioplasty and then dissolves over time is an attractive concept. It could solve the limitations of metallic stents, namely late stent thrombosis, restricted vasomotor function, and chronic local arterial inflammation. Additional potential advantages include decreased duration of dual-antiplatelet therapy, increased lumen size, greater ease in imaging (that is, computed tomography or magnetic resonance imaging) the treated vessel after revascularization, and more options to manage future target vessel revascularization (that is, repeated stenting and coronary artery bypass grafting).In light of these characteristics, this new approach to coronary ...References1. Farooq V, Fraser DG, El-Omar M, Mamas MA, Clarke B, Fath-Ordoubadi F. Lessons from acute and late scaffold failures in the ABSORB EXTEND trial: have we really learned them all? [Editorial]. EuroIntervention. 2014;10:419-23. [PMID: 25138179] doi:10.4244/EIJV10I4A73 CrossrefMedlineGoogle Scholar2. Zhang XL, Zhu L, Wei ZH, Zhu QQ, Qiao JZ, Dai Q, et al. Comparative efficacy and safety of everolimus-eluting bioresorbable scaffold with everolimus-eluting metallic stents. A systematic review and meta-analysis. Ann Intern Med. 2016;164:752-63. doi:10.7326/M16-0006 LinkGoogle Scholar3. Ellis SG, Kereiakes DJ, Metzger DC, Caputo RP, Rizik DG, Teirstein PS, et al; ABSORB III Investigators. Everolimus-eluting bioresorbable scaffolds for coronary artery disease. N Engl J Med. 2015;373:1905-15. [PMID: 26457558] doi:10.1056/NEJMoa1509038 CrossrefMedlineGoogle Scholar4. Cassese S, Byrne RA, Ndrepepa G, Kufner S, Wiebe J, Repp J, et al. Everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting metallic stents: a meta-analysis of randomised controlled trials. Lancet. 2016;387:537-44. [PMID: 26597771] doi:10.1016/S0140-6736(15)00979-4 CrossrefMedlineGoogle Scholar5. Jeremias A, Kirtane A. Balancing efficacy and safety of drug-eluting stents in patients undergoing percutaneous coronary intervention. Ann Intern Med. 2008;148:234-8. [PMID: 18087049] LinkGoogle Scholar6. Stefanini GG, Holmes DR. Drug-eluting coronary-artery stents. N Engl J Med. 2013;368:254-65. [PMID: 23323902] doi:10.1056/NEJMra1210816 CrossrefMedlineGoogle Scholar7. Tamburino C, Capranzano P, Gori T, Latib A, Lesiak M, Nef H, et al. 1-year outcomes of everolimus-eluting bioresorbable scaffolds versus everolimus-eluting stents: a propensity-matched comparison of the GHOST-EU and XIENCE V USA registries. JACC Cardiovasc Interv. 2016;9:440-9. [PMID: 26875648] doi:10.1016/j.jcin.2015.10.042 CrossrefMedlineGoogle Scholar8. Circulatory System Devices Panel of the Medical Devices Advisory Committee. Accessed at www.fda.gov/advisorycommittees/calendar/ucm481684.htm on 31 March 2016. Google Scholar9. Abbott's AbsorbTM, the First Fully Dissolving Heart Stent, Earns Positive Review by FDA Advisory Committee. Accessed at www.prnewswire.com/news-releases/abbotts-absorb-the-first-fully-dissolving-heart-stent-earns-positive-review-by-fda-advisory-committee-300236598.html on 31 March 2016. Google Scholar Author, Article, and Disclosure InformationAffiliations: From Johns Hopkins University School of Medicine, Baltimore, Maryland.Acknowledgment: The authors thank Jack L. Martin, MD, for input on a draft of the editorial.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-0754.Corresponding Author: Seth S. Martin, MD, MHS, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287; e-mail [email protected]edu.Current Author Addresses: Drs. Martin and Hasan: Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287.This article was published at www.annals.org on 5 April 2016. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 7 June 2016Volume 164, Issue 11Page: 775-776KeywordsLesionsMortalityMyocardial infarctionOdds ratioPopulation statisticsRandomized trialsRevascularizationSafetyStent implantationThrombosis ePublished: 3 May 2016 Issue Published: 7 June 2016 Copyright & PermissionsCopyright © 2016 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...