Additional material regarding the potential for bioresorbable scaffolds are listed below.
- “Challenges Related to Development of Bioabsorbable Vascular Stents” (Eurointervention Supplement: 2009; Volume 5, Supplement F), Joseph Berglund, PhD; Ya Guo, PhD; Josiah N. Wilcox, PhD.
This article establishes the current unmet clinical needs with bare metal stents and drug eluting stents, for both coronary and peripheral indications. It highlights the opportunity for a bioabsorbable stent which would return the vessel to a more natural state, facilitate re-interventions if needed, support a wider range of imaging modalities, and minimize the duration of dual antiplatelet therapy. The article describes the Medtronic Cardiovascular bioabsorbable program, focused on development of a degradable stent for superficial femoral arteries, with a targeted degradation of 12 months. The discussion summarizes the properties of an ideal stent and the challenges of selecting a material which balances trade-offs with respect to: mechanical properties and stent design, degradation rates and mechanical properties, and degradation rates and biocompatibility/safety.
- “Coronary Stents: Looking Forward” (Journal of the American College of Cardiology: 31 August 2010; Volume 56, Issue 10), Scot Garg, MB, ChB and Patrick W. Serruys, MD, PhD.
This paper discusses long term safety concerns of drug-eluting stents (DES), relating to stent thrombosis. In this context, it presents and details newer stents under development, some of which are currently undergoing pre-clinical and clinical trials. Specifically, DES with biodegradable polymers, DES that are polymer free, stents with novel coatings, and fully biodegradable stents are reviewed. In addition, bifurcation stents and drug-eluting balloons are also discussed as innovative devices aimed at addressing current limitations of coronary stents.
- “Contemporary Reviews in Interventional Cardiology: Bioabsorbable Coronary Stents” (Cardiovascular Interventions: 2009; 2-255-260), John A. Ormiston, MBChB and Patrick W.S. Serruys, MD, PhD.
The article reviews and summarizes different bioabsorbable stents that have been studied clinically: Igaki-Tamai Bioabsorbable Stent, Biotronik Bioabsorbable Magnesium Stent, BVS Everolimus-Eluting Bioabsorbable PLLA Stent, REVA Bioresorbable Polycarbonate Polymer Stent, and Bioabsorbable Therapeutics Stent. The Igaki-Tamai, a poly-L-lactic acid (PLLA) stent, is highlighted as the first absorbable stent implanted in humans. Results from the BVS everolimus-eluting stent are discussed, including clinical and imaging outcomes similar to those results following drug-eluting stent implantation for 2 years, with potential advantages of full stent absorption. The article concludes with a discussion of the duration of the need for mechanical support following percutaneous coronary intervention (PCI) and the potential reduction of late stent thrombosis risk.