Dual antiplatelet therapy, drug-eluting stents and bioresorbable vascular scaffolds: Evolutionary perspectives

Felipe N. Albuquerque, Anna Bortnick, Javaid Iqbal, Yuki Ishibashi, Gregg W. Stone, Patrick W. Serruys

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Dual antiplatelet therapy reduces the risk of myocardial infarction, stent thrombosis, and cardiovascular mortality after percutaneous coronary intervention, but the optimal duration of therapy remains unclear. Stent thrombosis, one of the most feared complications of coronary intervention, is associated with high mortality and morbidity and is related in part to technical and patient-specific factors. Advances in device technology and better understanding of the pathophysiology of stent thrombosis have reduced the frequency of this devastating complication. Bioresorbable vascular scaffolds possess a number of advantageous features and are currently undergoing active investigation. Bioresorbable vascular scaffolds have been demonstrated to restore physiologic vasomotion, allow for late lumen enlargement, and upon full resorption remove the nidus for very late polymer reactions and resolve concerns of stent malapposition and side branch jailing. Based on the results from recent large-scale randomized trials, the optimal duration of dual antiplatelet therapy may depend on the choice of device type, as well as the individual patient risk of ischemic versus hemorrhagic complications.

Original languageEnglish (US)
Pages (from-to)909-919
Number of pages11
JournalCatheterization and Cardiovascular Interventions
Volume87
Issue number5
DOIs
StatePublished - Apr 1 2016

Keywords

  • bioresorbable vascular scaffolds
  • dual anti-platelet therapy
  • stent thrombosis

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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