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  • Spreading New (OCT-) Light on Bioresorbable Vascular Scaffolds' Performance. Can the Future of BRS Become Brighter?

    With thousands of devices implanted and a consistent body of research developed in the last years, the 4th revolution of bioresorbable vascular scaffolds (BRS) has represented so far only an unfulfilled idea. The ambitious goal of the vascular restoration therapy with fully-resorbable and drug-eluting devices has – with a general disappointment – led to uncertainty and suspicion. Indeed results from the AIDA and the Absorb trials have shown an unacceptably high rates of late and very-late scaffold thrombosis (ST), leading to the end of Absorb-BRS (Abbott Vascular, Santa Clara, California) and to a drastic limitation of all BRS adoption in the western countries. More specifically, the randomized trial from Wykrzykowska et al. disclosed an incidence of ST of 3.5% (vs 0.9% in the conventional DES group, < 0.001) and the meta-analysis from the Absorb Trials showed about 2.4% of ST against 0.6% in the control group. These outcomes were associated with a significantly higher incidence of target lesion revascularization (TLR) and, more importantly, with increased rates of myocardial infarction (MIs).

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