Unit of Interventional and Clinical Cardiology, S. Ambrogio Cardio-Thoracic Center, Milan, Italy -
Unit of Interventional and Clinical Cardiology, S. Ambrogio Cardio-Thoracic Center, Milan, Italy.
Minerva Cardioangiol. 2020 Oct;68(5):415-435. doi: 10.23736/S0026-4725.20.05188-9. Epub 2020 Jul 8.
Bioresorbable scaffolds (BRS) have been introduced in the last decade in percutaneous coronary interventions. Despite several advantages being postulated, the negative results from the mid-term follow-up of the Absorb trials have tempered enthusiasm for these innovative devices. The Absorb scaffold was associated with higher rates of target-lesion failure and scaffold thrombosis when compared to current metallic stents, and for this reason was withdrawn from the market. This failure has to be considered multifactorial, involving technical and technological aspects. Continuous engineering refinements in BRS technology, means newer-generation devices are available in clinical practice, and several more are under preclinical and clinical assessment. Thinner and smaller struts, associated with a faster resorption and reendothelialization process, are at the basis of promising preclinical results for new BRS. In this review we summarize the Absorb scaffold experience and focus on the latest evidence concerning emerging new BRS, to explore if a "BRS revival" is conceivable.
生物可吸收支架（BRS）在过去十年中已被引入经皮冠状动脉介入治疗中。尽管有几个优点被假定，但 Absorb 试验的中期随访结果降低了对这些创新设备的热情。与当前的金属支架相比，Absorb 支架与更高的靶病变失败率和支架血栓形成相关，因此已从市场上撤出。这种失败必须被认为是多因素的，涉及技术和技术方面。BRS 技术的持续工程改进意味着新一代设备可用于临床实践，还有更多的设备正在进行临床前和临床评估。更薄、更小的支柱，与更快的吸收和再内皮化过程相关，是新的 BRS 具有有前途的临床前结果的基础。在这篇综述中，我们总结了 Absorb 支架的经验，并重点介绍了新兴的新型 BRS 的最新证据，以探讨是否可以“重新启用 BRS”。
