EBC - ON DEMAND
BVS Concerns after Absorb II and III : Operators, device or concept?
European Bifurcation Club 2017 – EBC 2017 – Porto, Portugal
SESSION 4: BRS for Bifurcation Stenting: After Thrombosis Crisis
BVS Concerns after Absorb II and III : Operators, device or concept?
Author: Yoshinobu Onuma, MD. PhD, Erasmus MC/ Cardialysis, Rotterdam, NL
SUMMARY
- Fully bioresorbable scaffold is designed to provide a temporary mechanical support and thereafter to disappear. In concept, improvement of very late outcomes could occur, after completion of bioresorption (>3 years).
- After Absorb II and III, meta-analysis demonstrated an increased risk of early/late and very late scaffold thrombosis (up to 2 years), resulting discontinuation of commercial production of Absorb.
- Occurrence of VLScT is related to underexpansion on IVUS. One of the underlying mechanisms is late structural discontinuities. A few data showed a relation between DAPT discontinuation and VLScT.
- Appropriate sizing and intense postdilatation may improve the outcome buy achieving better scaffold expansion and better embedment of struts.
- Improvement of clinical outcomes before completion of bioresorption (Non-inferiority to DES at that timepoint) is essential for BRS. New generation device is warranted (See the last talk of this session)