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Review
. 2017 Nov;47(6):795-810.
doi: 10.4070/kcj.2017.0300. Epub 2017 Nov 6.

Bioresorbable Vascular Scaffold Korean Expert Panel Report

Jung Min Ahn  1 , Duk Woo Park  1 , Sung Jin Hong  2 , Young Keun Ahn  3 , Joo Yong Hahn  4 , Won Jang Kim  5 , Soon Jun Hong  6 , Chang Wook Nam  7 , Do Yoon Kang  1 , Seung Yul Lee  8 , Woo Jung Chun  9 , Jung Ho Heo  10 , Deok Kyu Cho  11 , Jin Won Kim  12 , Sung Ho Her  13 , Sang Wook Kim  14 , Sang Yong Yoo  15 , Myeong Ki Hong  2 , Seung Jea Tahk  16 , Kee Sik Kim  17 , Moo Hyun Kim  18 , Yangsoo Jang  2 , Seung Jung Park  19
Affiliations
Review

Bioresorbable Vascular Scaffold Korean Expert Panel Report

Jung Min Ahn et al. Korean Circ J. 2017 Nov.

Abstract

Bioresorbable vascular scaffold (BRS) is an innovative device that provides structural support and drug release to prevent early recoil or restenosis, and then degrades into nontoxic compounds to avoid late complications related with metallic drug-eluting stents (DESs). BRS has several putative advantages. However, recent randomized trials and registry studies raised clinical concerns about the safety and efficacy of first generation BRS. In addition, the general guidance for the optimal practice with BRS has not been suggested due to limited long-term clinical data in Korea. To address the safety and efficacy of BRS, we reviewed the clinical evidence of BRS implantation, and suggested the appropriate criteria for patient and lesion selection, scaffold implantation technique, and management.

Keywords: Bioresorbable vascular scaffold; Coronary disease; Stents; Thrombosis.

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Conflict of interest statement

The authors have no financial conflicts of interest.

Figures

Figure 1
Figure 1
Scaffold biodegradation. (A) Hydrolysis randomly cleaves amorphous tie chains, leading to a decrease in molecular weight without altering radial strength. (B) When enough tie chains are broken, the device begins losing radial strength. After 2–3 years, BRS was fully bioresorbed. BRS = bioresorbable vascular scaffold.
Figure 2
Figure 2
A case of acute scaffold thrombosis. (A) Baseline coronary angiography, (B) after Absorb 3.0×23 mm BRS implantation, (C) follow-up coronary angiography due to chest pain with ST elevation after 7 hours, (D) OCT showing acute scaffold thrombosis with underexpansion and malapposition, (E) final angiography after high-pressure balloon dilatation, and (F) final OCT image showing well-apposed scaffold. BRS = bioresorbable vascular scaffold; OCT = optical coherent tomography.
Figure 3
Figure 3
Meta-analysis from 7 randomized trials: 2 year outcomes. BRS = bioresorbable vascular scaffold; CI = confidence interval; EES = everolimus-eluting stent; RR = relative risk; TLR = target lesion revascularization; TV-MI = target vessel myocardial infarction.
Figure 4
Figure 4
BRS specific implantation protocol. BRS specific implantation protocol was associated with about 70% reduction of scaffold thrombosis. BRS = bioresorbable vascular scaffold.
Figure 5
Figure 5
A case of “Effective” PSP. Fifty-seven years old man admitted due to effort related chest pain. Coronary angiography showed tight stenosis of LAD artery (A). On-line QCA showed that proximal Dmax was 3.1 mm and distal Dmax was 2.6 mm (E-G). Predilatation was performed using 3.5×1.5 mm non-compliant balloon (B). Absorb BRS 3.0×23 mm was implanted (C). Postdilatation was done by 3.5×15 mm non-compliant balloon up to 18 atm (final balloon diameter: 3.6 mm). Final optimal coherent tomography showed well expanded and apposed scaffold without acute complications. BRS = bioresorbable vascular scaffold; Dmax = maximal lumen diameter; LAD = left anterior descending; MLD = mean lung dose; NC = non-compliant; PSP = preparation, sizing, and postdilatation; QCA = quantitative coronary angiography; RVD = reference vessel diameter.
Figure 6
Figure 6
Optimal BRS outcomes. BRS = bioresorbable vascular scaffold; PSP = preparation, sizing, and postdilatation; QCA = quantitative coronary angiography.
See this image and copyright information in PMC

References

    1. Serruys PW, Chevalier B, Dudek D, et al. A bioresorbable everolimus-eluting scaffold versus a metallic everolimus-eluting stent for ischaemic heart disease caused by de-novo native coronary artery lesions (ABSORB II): an interim 1-year analysis of clinical and procedural secondary outcomes from a randomised controlled trial. Lancet. 2015;385:43–54. - PubMed
    1. Karanasos A, Simsek C, Gnanadesigan M, et al. OCT assessment of the long-term vascular healing response 5 years after everolimus-eluting bioresorbable vascular scaffold. J Am Coll Cardiol. 2014;64:2343–2356. - PubMed
    1. Brugaletta S, Radu MD, Garcia-Garcia HM, et al. Circumferential evaluation of the neointima by optical coherence tomography after ABSORB bioresorbable vascular scaffold implantation: can the scaffold cap the plaque? Atherosclerosis. 2012;221:106–112. - PubMed
    1. Simsek C, Karanasos A, Magro M, et al. Long-term invasive follow-up of the everolimus-eluting bioresorbable vascular scaffold: five-year results of multiple invasive imaging modalities. EuroIntervention. 2016;11:996–1003. - PubMed
    1. Serruys PW, Chevalier B, Sotomi Y, et al. Comparison of an everolimus-eluting bioresorbable scaffold with an everolimus-eluting metallic stent for the treatment of coronary artery stenosis (ABSORB II): a 3 year, randomised, controlled, single-blind, multicentre clinical trial. Lancet. 2016;388:2479–2491. - PubMed

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