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Since their introduction, bioresorbable vascular scaffolds (BVS) has been labelled as the forth revolution in interventional cardiology. Its development was mainly driven by the willing to overcome late metallic stent failure, such as neoatherosclerosis and thrombosis, and to avoid a permanent prosthesis inside coronary artery aiming to the so-called vascular restoration therapy.1 Efficacy and safety results in early observational studies and randomised clinical trials were comparable with those obtained with new-generation Drug eluting stent (DES) and accepted widely by the interventional cardiology community.2
Though this initial enthusiasm, recent findings from long-term studies have cooled the interest on these devices. Concerns have been raised in particular on an increased risk for both stent thrombosis (ST) and myocardial infarction (MI) after BVS implantation.3 4 On the top of this, the recent 3-year results of ABSORB II, which randomly assigned 501 patients to ABSORB or everolimus-eluting stent, showed not only significantly higher target vessel-related MI (6% vs 1%) and rates of ST and very late ST (VLST) (3% vs 0%) in the BVS arm but also lack of vasomotor reactivity difference in the two arms, with a larger late lumen loss in the ABSORB group.4
In the attempt to understand the real weight of these very late events, Nairooz et al 5 herein report the results of a meta-analysis of those …
Competing interests None declared.
Provenance and peer review Commissioned; internally peer reviewed.
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