04095nam a22005777a 4500
171212s20172017 xxu||||| |||| 00| 0 eng d
1936-8798
Ovid MEDLINE(R)
29216997
The State of the Absorb Bioresorbable Scaffold: Consensus From an Expert Panel. [Review]
Jacc: Cardiovascular Interventions. 10(23):2349-2359, 2017 Dec 11
JACC Cardiovasc Interv. 10(23):2349-2359, 2017 Dec 11
JACC. Cardiovascular interventions
2017
FY2018
2017-12-12
Available online through MWHC library: 2008 - present
Copyright (c) 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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.
English
*Absorbable Implants
*Coronary Artery Disease/th [Therapy]
*Drug-Eluting Stents
*Percutaneous Coronary Intervention/is [Instrumentation]
*Prosthesis Design
Clinical Decision-Making
Consensus
Coronary Artery Disease/dg [Diagnostic Imaging]
Coronary Restenosis/et [Etiology]
Coronary Thrombosis/et [Etiology]
Diffusion of Innovation
Evidence-Based Medicine
Humans
Patient Selection
Percutaneous Coronary Intervention/ae [Adverse Effects]
Prosthesis Failure
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome
MedStar Heart & Vascular Institute
MedStar Union Memorial Hospital
Journal Article
Review
Torguson, Rebecca
Waksman, Ron
Wang, John
Armstrong EJ, Attizzani GF, Avula SB, Bangalore S, Batchelor W, Bertolet BD, Bezerra HG, Caputo RP, Chehab BM, Choi JW, Chrysant GS, Dave RM, DeGregorio J, Ellis SG, Foster MT, Gigliotti OS, Gollapudi R, Gordon JB, Grines CL, Kaki A, Kalyanasundaram A, Kondur A, Korngold E, Li J, Maksoud A, Matar F, Merritt RF, Murphy BE, Naidu SS, Nicholson W, Parikh MA, Potluri SP, Quesada R, Rizik DG, Samuels B, Shah AP, Spaedy AJ, Stys TP, Sumar R, Toma C, Torguson R, Waksman R, Wang JC, Yakubov SJ, Zidar JP
https://dx.doi.org/10.1016/j.jcin.2017.09.041
https://dx.doi.org/10.1016/j.jcin.2017.09.041
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2017-12-12
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29216997
29216997
2017-12-12
2017-12-12
ART
2880
2880