TY - JOUR
T1 - Bioresorbable Scaffolds for the Management of Coronary Bifurcation Lesions
AU - Kawamoto, Hiroyoshi
AU - Ruparelia, Neil
AU - Tanaka, Akihito
AU - Chieffo, Alaide
AU - Latib, Azeem
AU - Colombo, Antonio
N1 - Publisher Copyright:
© 2016 American College of Cardiology Foundation.
PY - 2016/5/23
Y1 - 2016/5/23
N2 - The use of bioresorbable scaffolds (BRS) may be associated with benefits including restoration of endothelial function, positive vessel remodeling, and reduced risk for very late (stent) thrombosis compared with metallic stents by virtue of their complete absorption within 3 to 4 years of implantation. When treating bifurcation lesions, these advantages may be even more pronounced. The aim of this review is to summarize current experiences and technical considerations of bifurcation treatment with BRS. Because of the physical properties of current-generation BRS, there are concerns with regard to the efficacy and safety of this novel technology for the treatment of bifurcations, with the potential for increased rates of scaffold thrombosis and side-branch occlusions, and as a consequence, bifurcations have been excluded from the major BRS trials. Nevertheless, BRS have been used for this indication in clinical practice, as evidenced by "real-world" registries. Considering the potential limitations, specific technical considerations and modified bifurcation strategies should be used in an attempt to attenuate problems and achieve optimal procedural and clinical outcomes.
AB - The use of bioresorbable scaffolds (BRS) may be associated with benefits including restoration of endothelial function, positive vessel remodeling, and reduced risk for very late (stent) thrombosis compared with metallic stents by virtue of their complete absorption within 3 to 4 years of implantation. When treating bifurcation lesions, these advantages may be even more pronounced. The aim of this review is to summarize current experiences and technical considerations of bifurcation treatment with BRS. Because of the physical properties of current-generation BRS, there are concerns with regard to the efficacy and safety of this novel technology for the treatment of bifurcations, with the potential for increased rates of scaffold thrombosis and side-branch occlusions, and as a consequence, bifurcations have been excluded from the major BRS trials. Nevertheless, BRS have been used for this indication in clinical practice, as evidenced by "real-world" registries. Considering the potential limitations, specific technical considerations and modified bifurcation strategies should be used in an attempt to attenuate problems and achieve optimal procedural and clinical outcomes.
KW - bioresorbable scaffold
KW - coronary bifurcation
KW - percutaneous coronary intervention
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U2 - 10.1016/j.jcin.2016.02.038
DO - 10.1016/j.jcin.2016.02.038
M3 - Review article
C2 - 27198679
AN - SCOPUS:84968879624
SN - 1936-8798
VL - 9
SP - 989
EP - 1000
JO - JACC: Cardiovascular Interventions
JF - JACC: Cardiovascular Interventions
IS - 10
ER -