TY  - BOOK
AU  - Torguson, Rebecca
AU  - Waksman, Ron
AU  - Wang, John
TI  - The State of the Absorb Bioresorbable Scaffold: Consensus From an Expert Panel. [Review]
SN  - 1936-8798
PY  - 2017///
KW  - *Absorbable Implants
KW  - *Coronary Artery Disease/th [Therapy]
KW  - *Drug-Eluting Stents
KW  - *Percutaneous Coronary Intervention/is [Instrumentation]
KW  - *Prosthesis Design
KW  - Clinical Decision-Making
KW  - Consensus
KW  - Coronary Artery Disease/dg [Diagnostic Imaging]
KW  - Coronary Restenosis/et [Etiology]
KW  - Coronary Thrombosis/et [Etiology]
KW  - Diffusion of Innovation
KW  - Evidence-Based Medicine
KW  - Humans
KW  - Patient Selection
KW  - Percutaneous Coronary Intervention/ae [Adverse Effects]
KW  - Prosthesis Failure
KW  - Risk Assessment
KW  - Risk Factors
KW  - Time Factors
KW  - Treatment Outcome
KW  - MedStar Heart & Vascular Institute
KW  - MedStar Union Memorial Hospital
KW  - Journal Article
KW  - Review
N1  - Available online through MWHC library: 2008 - present
N2  - 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
UR  - https://dx.doi.org/10.1016/j.jcin.2017.09.041
ER  -