Are bioresorbable coronary scaffolds ready for a comeback?


Take Home Messages
  • Given the history with the first-generation BRS, large-scale randomised trials are required before the clinical community will adopt the next generation of devices.
  • The evidence currently available is insufficient to justify the implantation of BRS outside of clinical trials.
  • Given the efficacy and safety of current DES, even with reduced antiplatelet therapy, there is no urgent need to run this risk again, allowing for a robust resurgence of BRS technology.

In percutaneous coronary intervention (PCI), the concept of securing metal free angioplasty without leaving behind a permanent foreign body is highly attractive to patients and physicians and promises several advantages. However, target lesion failure and device thrombosis were important concerns with first-generation Bioresorbable scaffolds (BRS) leading to low rates of adoption in clinical practice (1-12). New iterations, incorporating improvements such as a smaller strut thickness have been proposed and evaluated in early investigations. However, it remains unclear whether these modifications are sufficient to achieve outcomes comparable to those of metallic drug-eluting stents (DES) while preserving the benefits of resorption (10-12).