title: Bioresorbable Vascular Scaffolds for Coronary Revascularization.
abstract: Contemporary metallic drug-eluting stents are associated with very good 1-year outcomes but an ongoing risk of stent-related adverse events (thrombosis, myocardial infarction, restenosis) after 1 year. The pathogenesis of these very late events is likely related to the permanent presence of the metal stent frame or polymer. Bioresorbable scaffolds have been developed to provide drug delivery and mechanical support functions similar to metallic drug-eluting stents, followed by complete resorption with recovery of more normal vascular structure and function, potentially improving very late clinical outcomes. A first-generation bioresorbable scaffold has been demonstrated to be noninferior to a contemporary metallic drug-eluting stents for overall 1-year patient-oriented and device-oriented outcomes. Increased rates of scaffold thrombosis and target vessel-related myocardial infarction were noted that may be mitigated by improved patient and lesion selection, procedural technique, and device iteration. Large-scale, randomized, clinical trials are ongoing to determine the long-term relative efficacy and safety of bioresorbable scaffolds compared with current metallic drug-eluting stents.
authors.affiliation: From The Christ Hospital, Heart and Vascular Center, Lindner Research Center, Cincinnati, OH (D.J.K.); Thorax Centre, Erasmus MC, Rotterdam, The Netherlands (Y.O.); International Centre for Cardiovascular Health, Imperial College, London, UK (P.W.S.); and New York Presbyterian Hospital, Columbia University Medical Center, and the Cardiovascular Research Foundation, New York (G.W.S.). lindner@thechristhospital.com.
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Kereiakes
authors.affiliation: From The Christ Hospital, Heart and Vascular Center, Lindner Research Center, Cincinnati, OH (D.J.K.); Thorax Centre, Erasmus MC, Rotterdam, The Netherlands (Y.O.); International Centre for Cardiovascular Health, Imperial College, London, UK (P.W.S.); and New York Presbyterian Hospital, Columbia University Medical Center, and the Cardiovascular Research Foundation, New York (G.W.S.).
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Onuma
authors.affiliation: From The Christ Hospital, Heart and Vascular Center, Lindner Research Center, Cincinnati, OH (D.J.K.); Thorax Centre, Erasmus MC, Rotterdam, The Netherlands (Y.O.); International Centre for Cardiovascular Health, Imperial College, London, UK (P.W.S.); and New York Presbyterian Hospital, Columbia University Medical Center, and the Cardiovascular Research Foundation, New York (G.W.S.).
authors.forename: Patrick W
authors.initials: PW
authors.lastname: Serruys
authors.affiliation: From The Christ Hospital, Heart and Vascular Center, Lindner Research Center, Cincinnati, OH (D.J.K.); Thorax Centre, Erasmus MC, Rotterdam, The Netherlands (Y.O.); International Centre for Cardiovascular Health, Imperial College, London, UK (P.W.S.); and New York Presbyterian Hospital, Columbia University Medical Center, and the Cardiovascular Research Foundation, New York (G.W.S.).
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
mesh_terms: D020341:Absorbable Implants / Q000009:adverse effects; D000497:Alloys; D000818:Animals; D023903:Coronary Restenosis / Q000517:prevention & control; D023921:Coronary Stenosis / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008274:Magnesium; D015201:Meta-Analysis as Topic; D016032:Randomized Controlled Trials as Topic; D000072657:ST Elevation Myocardial Infarction / Q000628:therapy; D013552:Swine; D013556:Swine, Miniature; D054457:Tissue Scaffolds / Q000009:adverse effects; D041623:Tomography, Optical Coherence
chemical_list: D000497:Alloys; D008274:Magnesium
keywords: angioplasty; revascularization; stents