Drug-eluting bioresorbable scaffolds in cardiovascular disease, peripheral artery and gastrointestinal fields: a clinical update

Expert Opin Drug Deliv. 2020 Jul;17(7):931-945. doi: 10.1080/17425247.2020.1764932. Epub 2020 May 27.

Abstract

Introduction: The technology of bioresorbable scaffold (BRS) spread out after the success of the first-in-man trials of the Absorb. However, the randomized trials demonstrated that major adverse cardiac events and scaffold thrombosis rates of the first-generation Absorb were higher than those of the metallic everolimus-eluting stent. To overcome the shortcoming of the firstly commercialized Absorb, novel technologies have been developed.

Areas covered: In this review, we overviewed the field of BRS in the treatment of coronary, peripheral artery and gastrointestinal fields. To date, 10 BRS devices developed by 6 manufacturers have acquired the CE mark in coronary artery disease. Currently 8 BRS are in clinical trial phase, whereas 7 BRS are in preclinical assessment phase. Most new-generation devices have a strut thickness of less than 100 μm. However, late favorable outcome might be achieved not only by device refinement but also by a proper technique of implantation using intra vascular imaging guidance, as well as with a careful patient and lesion selection.

Expert opinion: New-generation BRS will be soon tested in the clinical arena to demonstrate improved acute and long-term of safety and efficacy.

Keywords: Bioresorbable scaffold; CE mark; absorb; new generation scaffold; scaffold thrombosis.

Publication types

  • Review

MeSH terms

  • Absorbable Implants*
  • Coronary Artery Disease / drug therapy
  • Drug-Eluting Stents*
  • Everolimus / administration & dosage
  • Humans
  • Peripheral Arterial Disease / drug therapy*
  • Tissue Scaffolds
  • Treatment Outcome

Substances

  • Everolimus