title: [Bioresorbable vascular scaffolds: clinical experience of the Emilia-Romagna Region, Italy].
abstract: The bioresorbable vascular scaffold (BRS) technology constitutes the new revolution of the coronary artery disease interventional treatment. Currently, three distinct types of BRSs are available but only one, the Absorb BVS, was on the market in 2013 when the Regional Commission for Medical Devices and the Cardiology and Cardiac Surgery Commission of the Emilia-Romagna Region drew up a technical and scientific essay to provide guidance for the introduction of BRS in public and affiliated health facilities. Five preferential indications were given for use: long coronary lesions (>28 mm), ostial lesions (left main stem excluded), complete revascularization in patients aged <50 years, diffuse disease (>40 mm) or involving the mid/distal left anterior descending (LAD) branch in patients <70 years, spontaneous coronary artery dissection.
  
  
  
  This survey analyzed data from all the catheterization laboratories in the Emilia-Romagna Region, merged in a unified database.
  
  
  
  In a 3-year study period, 546 BRS were implanted in 328 patients, corresponding to 1.5% of the drug-eluting stents (DES) used, with a trend towards a progressive increase over time. Initial indications were followed in 200/328 (61.0%) patients (about one third fitting more indications), mainly for treatment of long lesions in vessels >2.5 mm (67%), young patients (31.5%) and mid/distal LAD (28%). In 22.6% of cases the clinical scenario was a ST-segment elevation myocardial infarction, in 39.3% a non-ST-segment elevation acute coronary syndrome. Intracoronary imaging was infrequently used (intravascular ultrasound in 24.7% of cases). In 85 patients (25.9%) a hybrid procedure (BVS/DES) was performed.
  
  
  
  BRS use has resulted lower than expected, with discrete variability among centers, but according to the initial indications of the Emilia-Romagna Region in the majority of cases. The underuse might have been due to operators' caution in their initial experience. However, the increasing trend may reveal a greater confidence in the implantation technique and the whole amount of safety and efficacy data.
authors.affiliation: U.O. Cardiologia, Azienda Ospedaliero-Universitaria di Parma.
authors.forename: Alberto
authors.initials: A
authors.lastname: Menozzi
authors.affiliation: U.O. Cardiologia, Azienda Ospedaliera Universitaria di Ferrara.
authors.forename: Gianluca Calogero
authors.initials: GC
authors.lastname: Campo
authors.affiliation: U.O. Cardiologia Interventistica, IRCCS S. Maria Nuova, Reggio Emilia.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Guiducci
authors.affiliation: U.O. Cardiologia, Ospedale Morgagni-Pierantoni, Forlì.
authors.forename: Gianni
authors.initials: G
authors.lastname: Dall'Ara
authors.affiliation: U.O. Cardiologia, Ospedale degli Infermi, Rimini.
authors.forename: Andrea
authors.initials: A
authors.lastname: Santarelli
authors.affiliation: Laboratorio di Cardio-Angiologia Diagnostica ed Interventistica, Maria Cecilia Hospital - GVM Care & Research, Cotignola (RA).
authors.forename: Paolo
authors.initials: P
authors.lastname: Sbarzaglia
authors.affiliation: U.O. Cardiologia, Ospedale Santa Maria delle Croci, Ravenna.
authors.forename: Marco
authors.initials: M
authors.lastname: Balducelli
authors.affiliation: U.O. Cardiologia, Ospedale di Baggiovara, Modena.
authors.forename: Paolo
authors.initials: P
authors.lastname: Magnavacchi
authors.affiliation: U.O. Cardiologia, Azienda Policlinico, Modena.
authors.forename: Fabio
authors.initials: F
authors.lastname: Sgura
authors.affiliation: U.O. Cardiologia, Ospedale Guglielmo da Saliceto, Piacenza.
authors.forename: Luciano
authors.initials: L
authors.lastname: Losi
authors.affiliation: U.O. Cardiologia, Azienda Ospedaliero-Universitaria di Parma.
authors.forename: Luigi
authors.initials: L
authors.lastname: Vignali
authors.affiliation: U.O. Cardiologia, Ospedale Maggiore, Bologna.
authors.forename: Gianni
authors.initials: G
authors.lastname: Casella
authors.affiliation: U.O. Cardiologia, Hesperia Hospital, Modena.
authors.forename: Luigi
authors.initials: L
authors.lastname: Steffanon
authors.affiliation: U.O. Cardiologia, Ospedale Morgagni-Pierantoni, Forlì.
authors.forename: Fabio
authors.initials: F
authors.lastname: Tarantino
authors.affiliation: U.O. Cardiologia, Policlinico S. Orsola-Malpighi, Bologna.
authors.forename: Francesco
authors.initials: F
authors.lastname: Saia
mesh_terms: D020341:Absorbable Implants; D001807:Blood Vessel Prosthesis; D003324:Coronary Artery Disease / Q000601:surgery*; D003331:Coronary Vessels / Q000601:surgery*; D006801:Humans; D007558:Italy; D011474:Prosthesis Design; D016032:Randomized Controlled Trials as Topic; D054457:Tissue Scaffolds