Citation: Jacc: Cardiovascular Interventions. 10(23):2349-2359, 2017 Dec 11.Journal: JACC. Cardiovascular interventions.Published: 2017ISSN: 1936-8798.Full author list: Bangalore S; Bezerra HG; Rizik DG; Armstrong EJ; Samuels B; Naidu SS; Grines CL; Foster MT; Choi JW; Bertolet BD; Shah AP; Torguson R; Avula SB; Wang JC; Zidar JP; Maksoud A; Kalyanasundaram A; Yakubov SJ; Chehab BM; Spaedy AJ; Potluri SP; Caputo RP; Kondur A; Merritt RF; Kaki A; Quesada R; Parikh MA; Toma C; Matar F; DeGregorio J; Nicholson W; Batchelor W; Gollapudi R; Korngold E; Sumar R; Chrysant GS; Li J; Gordon JB; Dave RM; Attizzani GF; Stys TP; Gigliotti OS; Murphy BE; Ellis SG; Waksman R.UI/PMID: 29216997.Subject(s): *Absorbable Implants | Clinical Decision-Making | Consensus | Coronary Artery Disease/dg [Diagnostic Imaging] | *Coronary Artery Disease/th [Therapy] | Coronary Restenosis/et [Etiology] | Coronary Thrombosis/et [Etiology] | Diffusion of Innovation | *Drug-Eluting Stents | Evidence-Based Medicine | Humans | Patient Selection | Percutaneous Coronary Intervention/ae [Adverse Effects] | *Percutaneous Coronary Intervention/is [Instrumentation] | *Prosthesis Design | Prosthesis Failure | Risk Assessment | Risk Factors | Time Factors | Treatment OutcomeInstitution(s): MedStar Heart & Vascular Institute | MedStar Union Memorial HospitalActivity type: Journal Article.Medline article type(s): Journal Article | ReviewOnline resources: Click here to access onlineDigital Object Identifier: https://dx.doi.org/10.1016/j.jcin.2017.09.041 (Click here)Abbreviated citation: JACC Cardiovasc Interv. 10(23):2349-2359, 2017 Dec 11.Local Holdings: Available online through MWHC library: 2008 - present.Abstract: Significant progress has been made in the percutaneous coronary intervention technique from the days of balloon angioplasty to modern-day metallic drug-eluting stents (DES). Although metallic stents solve a temporary problem of acute recoil following balloon angioplasty, they leave behind a permanent problem implicated in very late events (in addition to neoatherosclerosis). BRS were developed as a potential solution to this permanent problem, but the promise of these devices has been tempered by clinical trials showing increased risk of safety outcomes, both early and late. This is not too dissimilar to the challenges seen with first-generation DES in which refinement of deployment technique, prolongation of dual antiplatelet therapy, and technical iteration mitigated excess risk of very late stent thrombosis, making DES the treatment of choice for coronary artery disease. This white paper discusses the factors potentially implicated in the excess risks, including the scaffold consideration and deployment technique, and outlines patient and lesion selection, implantation technique, and dual antiplatelet therapy considerations to potentially mitigate this excess risk with the first-generation thick strut Absorb scaffold (Abbott Vascular, Abbott Park, Illinois). It remains to be seen whether these considerations together with technical iterations will ultimately close the gap between scaffolds and metal stents for short-term events while at the same time preserving options for future revascularization once the scaffold bioresorbs.Abstract: Copyright (c) 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.