The Present and Future
Review Topic of the Week
Current Status of Bioresorbable Scaffolds in the Treatment of Coronary Artery Disease

https://doi.org/10.1016/j.jacc.2014.09.041Get rights and content
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Abstract

State-of-the-art drug-eluting metal stents are the gold standard for interventional treatment of coronary artery disease. Although they overcome some disadvantages and limitations of plain balloon angioplasty and bare-metal stents, some limitations apply, most notably a chronic local inflammatory reaction due to permanent implantation of a foreign body, restriction of vascular vasomotion due to a metal cage, and the risk of late and very late stent thrombosis. The development of biodegradable scaffolds is a new approach that attempts to circumvent these drawbacks. These devices provide short-term scaffolding of the vessel and then dissolve, which should theoretically circumvent the side effects of metal drug-eluting stents. Various types of these bioresorbable scaffolds are currently under clinical evaluation. This review discusses different concepts of bioresorbable scaffolds with respect to material, design, and drug elution and presents the most recent evidence.

Key Words

bioresorbable scaffold
coronary artery disease

Abbreviations and Acronyms

BRS
bioresorbable scaffold(s)
BVS
bioresorbable vascular scaffold
CE
Conformité Européenne
DES
drug-eluting stent(s)
IVUS
intravascular ultrasound
MACE
major adverse cardiac event(s)
OCT
optical coherence tomography
PCI
percutaneous coronary intervention
PLLA
poly-l-lactic acid
TLR
target lesion revascularization

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Dr. Nef has received research grant and honoraria for lectures from Abbott Vascular; and honoraria for lectures from Elixir Medical. Dr. Hamm has received honoraria for lectures from Abbott Vascular. Dr. Wiebe has reported that he has no relationships relevant to the contents of this paper to disclose.

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