Expert opinion on drug delivery · 2020
Drug-eluting bioresorbable scaffolds in cardiovascular disease, peripheral artery and gastrointestinal fields: a clinical update.
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Kawashima Hideyuki, Ono Masafumi, Kogame Norihiro, Takahashi Kuniaki, Chang Chun-Chin, Hara Hironori, Gao Chao, Wang Rutao, Tomaniak Mariusz, Modolo Rodrigo, Wykrzykowska Joanna J, De Winter Robbert J, Sharif Faisal, Serruys Patrick W, Onuma Yoshinobu
Аннотация
INTRODUCTION: The technology of bioresorbable scaffold (BRS) spread out after the success of the first-in-man trials of the Absorb. However, the randomized trials demonstrated that major adverse cardiac events and scaffold thrombosis rates of the first-generation Absorb were higher than those of the metallic everolimus-eluting stent. To overcome the shortcoming of the firstly commercialized Absorb, novel technologies have been developed.
AREAS COVERED: In this review, we overviewed the field of BRS in the treatment of coronary, peripheral artery and gastrointestinal fields. To date, 10 BRS devices developed by 6 manufacturers have acquired the CE mark in coronary artery disease. Currently 8 BRS are in clinical trial phase, whereas 7 BRS are in preclinical assessment phase. Most new-generation devices have a strut thickness of less than 100 μm. However, late favorable outcome might be achieved not only by device refinement but also by a proper technique of implantation using intra vascular imaging guidance, as well as with a careful patient and lesion selection.
EXPERT OPINION: New-generation BRS will be soon tested in the clinical arena to demonstrate improved acute and long-term of safety and efficacy.
AREAS COVERED: In this review, we overviewed the field of BRS in the treatment of coronary, peripheral artery and gastrointestinal fields. To date, 10 BRS devices developed by 6 manufacturers have acquired the CE mark in coronary artery disease. Currently 8 BRS are in clinical trial phase, whereas 7 BRS are in preclinical assessment phase. Most new-generation devices have a strut thickness of less than 100 μm. However, late favorable outcome might be achieved not only by device refinement but also by a proper technique of implantation using intra vascular imaging guidance, as well as with a careful patient and lesion selection.
EXPERT OPINION: New-generation BRS will be soon tested in the clinical arena to demonstrate improved acute and long-term of safety and efficacy.