title: Absorb bioresorbable vascular scaffold: What have we learned after 5 years of clinical experience?
abstract: Bioresorbable scaffolds have the potential to introduce a paradigm shift in interventional cardiology, a true anatomical and functional "vascular restoration" instead of an artificial stiff tube encased by persistent metallic foreign body. Early clinical studies using the first commercially available drug-eluting bioresorbable vascular scaffold (BVS) reported very promising safety and efficacy outcomes, comparable to best-in-class second-generation drug-eluting metal stent. To date, more than 60,000 Absorb BVSs have been implanted with only the interim analysis of one randomized trial (ABSORB II RCT) available. Recent registries have challenged the initial claim that BVS is immune from Scaffold Thrombosis (ST). However, suboptimal device expansion and insufficient intracoronary imaging guidance can explain higher than expected ST, especially in complex lesions. The aim of this review article is to critically evaluate the results of the available Absorb BVS studies and discuss the lessons learned to optimize lesion selection and implantation technique of such devices.
authors: Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy; Cardiovascular National Institute of Health Research Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors: Gianluca
authors: G
authors: Caiazzo
authors: Cardiovascular National Institute of Health Research Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors: Ismail Dogu
authors: ID
authors: Kilic
authors: Cardiovascular National Institute of Health Research Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom; Cardiovascular Department, "Ospedali Riuniti" & University of Trieste, Trieste, Italy.
authors: Enrico
authors: E
authors: Fabris
authors: Cardiovascular National Institute of Health Research Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom.
authors: Roberta
authors: R
authors: Serdoz
authors: Department of Heart and Vessels, AOUC Careggi, Florence, Italy.
authors: Alessio
authors: A
authors: Mattesini
authors: National Heart Centre Singapore, Singapore.
authors: Nicolas
authors: N
authors: Foin
authors: Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
authors: Salvatore
authors: S
authors: De Rosa
authors: Division of Cardiology, Department of Medical and Surgical Sciences, "Magna Graecia" University, Catanzaro, Italy.
authors: Ciro
authors: C
authors: Indolfi
authors: Cardiovascular National Institute of Health Research Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust, London, United Kingdom. Electronic address: c.dimario@rbht.nhs.uk.
authors: Carlo
authors: C
authors: Di Mario
mesh_terms: D020341:Absorbable Implants / Q000639:trends*; D000818:Animals; D001807:Blood Vessel Prosthesis / Q000639:trends*; D002986:Clinical Trials as Topic / Q000379:methods; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000453:epidemiology / Q000601:surgery*; D006801:Humans; D011474:Prosthesis Design / Q000379:methods / Q000639:trends; D013997:Time Factors; D054457:Tissue Scaffolds / Q000639:trends*; D016896:Treatment Outcome
keywords: Absorb; Bioresorbable vascular scaffold; Intracoronary imaging; Percutaneous coronary intervention