Outcomes of optimised implantation technique with bioresorbable scaffolds: A pooled analysis of ABSORB-IV and COMPARE-ABSORB trials.


Division of Cardiology, Ospedale Santa Corona, Pietra Ligure, Italy. Electronic address: [Email]


Randomised trials have demonstrated higher midterm rates of adverse events and device thrombosis with Absorb-BVS compared to contemporary drug-eluting-stents (DES). BVS failure was ascribed to the implantation technique and consequently two large randomised trials evaluated the clinical impact of an optimised scaffold-implant-procedure. However, pooling together data from ABSORB-IV and those of the COMPARE-ABSORB, the scaffold was still associated with a statistically significant increased risk of target-vessel myocardial-infarction (OR 1.5; 95% CI 1.04-2.17; P = 0.03) and thrombotic events (OR 2.85; 95% CI 1.33-6.11; P = 0.007) at 1-year. Such kind of results could be in part attributed to a lower radial force and the higher acute recoil of the BVS as observed in previous studies. Besides a painstaking implantation technique, future generations of bioresorbable stents should incorporate an excellent mechanical propriety in order to compete with the current-generation DES.

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