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  • Can We Keep Our Young Patients Free From Permanent Metallic Implants?

    Bioresorbable scaffolds (BRS) are appealing devices to prevent acute vessel re-occlusion after successful balloon dilatation of relevant coronary artery obstructions. Adding anti-inflammatory drugs reduces the vascular response to local injury resulting from balloon inflation and foreign material. With the proper dosage, a fast strut coverage without excessive neo-intima formation (experienced with bare metal stents) is possible. After this healing process, the metallic backbone does not have a true function anymore and clearly increases the rate of re-interventions versus balloon angioplasty only in the long run. A bioresorbable device that serves this purpose for the first 3 months and afterward disappears seems ideal for patient with a long life expectancy. Patients presenting with an ST-elevation myocardial infarction (STEMI) are in general younger and frequently have less extensive coronary atherosclerosis and are therefore ideal candidates for such, in general, more expensive technologies. Feasibility of the concept was first demonstrated in 2014. Yet the first generation of BRS has significant disadvantages because of the material limitations resulting in more bulky devices with unpolished, square, and dense struts with a thickness of 150 microns.

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