Bioresorbable Coronary Scaffold Technologies: What's New?

Despite some expected benefits of BRS, none of the available data have confirmed the advantage of the first-generation BRS over the metallic DES. Thus, the current generations of BRS, especially the Absorb BVS, should not be preferred to conventional DES in everyday clinical practice. To not leave behind the desirable vascular restoration therapy concept, the next generations of BRS should aim not only to improve the acute performance of the device but, above all, to improve long-term safety. Such developments might be achieved both by device improvement, but also with a proper technique of implantation, intravascular imaging guidance, as well as careful patient and lesion selection. Accordingly, new-generation devices have been developed with thinner struts, greater radial force and vessel wall coverage, less recoil and shorter resorption time with a lesser degree of inflammation secondary to polymer resorption. Reasonable long-term safety/efficacy evaluations are now recommended to establish comparable mid-term clinical outcomes and clear clinical advantages after complete resorption compared with currently available metallic DES.