Bioresorbable Scaffolds for the Management of Coronary Bifurcation Lesions

Abstract The use of bioresorbable scaffolds (BRS) may be associated with benefits including restoration of endothelial function, positive vessel remodeling, and reduced risk for very late (stent) thrombosis compared with metallic stents by virtue of their complete absorption within 3 to 4 years of i...

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Bibliographic Details
Published in:JACC. Cardiovascular interventions 2016-05, Vol.9 (10), p.989-1000
Main Authors: Kawamoto, Hiroyoshi, MD, Ruparelia, Neil, MBBS, DPhil, Tanaka, Akihito, MD, Chieffo, Alaide, MD, Latib, Azeem, MD, Colombo, Antonio, MD
Format: Article
Language:English
Subjects:
Absorbable Implants
bioresorbable scaffold
Cardiovascular
Coronary Angiography
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - therapy
coronary bifurcation
Coronary Vessels - diagnostic imaging
Humans
percutaneous coronary intervention
Percutaneous Coronary Intervention - adverse effects
Percutaneous Coronary Intervention - instrumentation
Prosthesis Design
Risk Factors
Time Factors
Tomography, Optical Coherence
Treatment Outcome
Ultrasonography, Interventional
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Summary:Abstract The use of bioresorbable scaffolds (BRS) may be associated with benefits including restoration of endothelial function, positive vessel remodeling, and reduced risk for very late (stent) thrombosis compared with metallic stents by virtue of their complete absorption within 3 to 4 years of implantation. When treating bifurcation lesions, these advantages may be even more pronounced. The aim of this review is to summarize current experiences and technical considerations of bifurcation treatment with BRS. Because of the physical properties of current-generation BRS, there are concerns with regard to the efficacy and safety of this novel technology for the treatment of bifurcations, with the potential for increased rates of scaffold thrombosis and side-branch occlusions, and as a consequence, bifurcations have been excluded from the major BRS trials. Nevertheless, BRS have been used for this indication in clinical practice, as evidenced by “real-world” registries. Considering the potential limitations, specific technical considerations and modified bifurcation strategies should be used in an attempt to attenuate problems and achieve optimal procedural and clinical outcomes.
ISSN:1936-8798
1876-7605
DOI:10.1016/j.jcin.2016.02.038