The DESolve® novolimus bioresorbable scaffold

2021 ◽  
Author(s):  
Pierluigi Demola ◽  
Francesco Meucci ◽  
Miroslava Stolcova ◽  
Carlo Di Mario ◽  
Alessio Mattesini
Keyword(s):  
Polymer Scaffold ◽  
Bioresorbable Scaffold ◽  
Incomplete Stent Apposition ◽  
Radial Strength ◽  
Vessel Patency ◽  
Vascular Scaffolds ◽  
Bioresorbable Vascular Scaffolds ◽  
Controversial Topic ◽  
Long Term Impact

A longtime aspiration of interventional cardiologists remains to improve the long-term impact of stent permanence in coronaries to restore original vessel patency and physiological endothelium response. Bioresorbable vascular scaffolds were considered revolutionary in coronary devices, but several trials were disappointing; thus, the challenge in this field remains. DESolve is a novolimus-eluting poly-L lactide-based polymer scaffold that dissolves through a bio-reabsorption mechanism, vanishing completely in 2 years. Its ability to supply the necessary radial strength to support the vessel for the critical early months after delivery is an important feature showing a unique self-correction property, which reduces incomplete stent apposition. Overexpansion has a good, safe margin with DESolve. This review aims to provide an overview of this controversial topic.

scholarly journals Bioresorbable Vascular Scaffolds—Dead End or Still a Rough Diamond?

2019 ◽  
Vol 8 (12) ◽  
pp. 2167 ◽  
Author(s):  
Mateusz P. Jeżewski ◽  
Michał J. Kubisa ◽  
Ceren Eyileten ◽  
Salvatore De Rosa ◽  
Günter Christ ◽  
...  
Keyword(s):  
Second Generation ◽  
Cardiac Events ◽  
Vasomotor Function ◽  
Dead End ◽  
Radial Strength ◽  
Vessel Patency ◽  
Vascular Scaffolds ◽  
Drug Eluting ◽  
Bioresorbable Vascular Scaffolds ◽  
First And Second Generation

Percutaneous coronary interventions with stent-based restorations of vessel patency have become the gold standard in the treatment of acute coronary states. Bioresorbable vascular scaffolds (BVS) have been designed to combine the efficiency of drug-eluting stents (DES) at the time of implantation and the advantages of a lack of foreign body afterwards. Complete resolution of the scaffold was intended to enable the restoration of vasomotor function and reduce the risk of device thrombosis. While early reports demonstrated superiority of BVS over DES, larger-scale application and longer observation exposed major concerns about their use, including lower radial strength and higher risk of thrombosis resulting in higher rate of major adverse cardiac events. Further focus on procedural details and research on the second generation of BVS with novel properties did not allow to unequivocally challenge position of DES. Nevertheless, BVS still have a chance to present superiority in distinctive indications. This review presents an outlook on the available first and second generation BVS and a summary of results of clinical trials on their use. It discusses explanations for unfavorable outcomes, proposed enhancement techniques and a potential niche for the use of BVS.

scholarly journals Bioresorbable vascular scaffolds in the routine clinical practice: long-term results

2020 ◽  
Author(s):  
Ricardo Mori-Junco ◽  
Luis Furuya-Kanamori ◽  
Pablo Salinas ◽  
Luis Nombela Franco ◽  
Pilar Jiménez Quevedo ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Routine Clinical Practice ◽  
Long Term Results ◽  
Vascular Scaffolds ◽  
Bioresorbable Vascular Scaffolds

scholarly journals Long-term clinical outcomes for bifurcation treatment using a provisional T-stenting and double proximal optimization technique with Absorb bioresorbable scaffolds

2017 ◽  
Vol 21 (1) ◽  
pp. 50
Author(s):  
R. D. Ivanchenko ◽  
A. V. Birukov ◽  
K. A. Smirnov
Keyword(s):  
Coronary Artery ◽  
Conflict Of Interest ◽  
Optimization Technique ◽  
Drug Eluting Stent ◽  
Long Term Follow Up ◽  
Vascular Scaffolds ◽  
Bioresorbable Vascular Scaffolds ◽  
Bifurcation Lesions

<p><strong>Aim.</strong> The article presents long-term outcomes of treatment of coronary artery bifurcation lesions by using bioresorbable vascular scaffolds and provisional T-stenting combined with double proximal optimization. <br /><strong>Methods.</strong> 14 patients aged 44-80 years (mean age 61±6 years) including 8 (57.14 %) males underwent endovascular treatment of coronary artery bifurcation lesions by using Absorb bioresorbable vascular scaffolds (BVS). Clinical/instrumental analysis was carried out after 23.7±4.12 months. Angiographic examination was performed in 12 cases (85.71 %). 7 patients (50 %) underwent optical coherent tomography. <br /><strong>Results.</strong> 11 patients (78.57) were free of angina during long-term follow-up. 1 patient (7.14 %) developed BVS thrombosis and received a drug-eluting stent. A neointimal layer of the main branch increased during long-term follow-up to 29.23±7.82%, that of the lateral branch – up to 19.2±7.48%. Optical coherence tomography (OCT) shows that all strata are fully covered with neointima, the number of strata with malappositions is minimal and the loss of the main branch diameter (16.9±4.9%) is insignificant. <br /><strong>Conclusion.</strong> The use of Absorb bioresorbable vascular scaffolds implanted by means of provisional T-stenting combined with double proximal optimization when treating coronary artery bifurcation lesions is a safe and efficient procedure.</p><p>Received 2 February 2017. Accepted 10 March 2017.</p><p><strong>Financing:</strong> The study did not have sponsorship.<br /><strong>Conflict of interest:</strong> The authors declare no conflict of interest.</p>

scholarly journals Crimping-induced structural gradients explain the lasting strength of poly l-lactide bioresorbable vascular scaffolds during hydrolysis

2018 ◽  
Vol 115 (41) ◽  
pp. 10239-10244 ◽  
Author(s):  
Karthik Ramachandran ◽  
Tiziana Di Luccio ◽  
Artemis Ailianou ◽  
Mary Beth Kossuth ◽  
James P. Oberhauser ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Heart Disease ◽  
Morphological Changes ◽  
Metal Stents ◽  
Radial Load ◽  
Late Stent Thrombosis ◽  
X Ray ◽  
Radial Strength ◽  
Vascular Scaffolds ◽  
Bioresorbable Vascular Scaffolds

Biodegradable polymers open the way to treatment of heart disease using transient implants (bioresorbable vascular scaffolds, BVSs) that overcome the most serious complication associated with permanent metal stents—late stent thrombosis. Here, we address the long-standing paradox that the clinically approved BVS maintains its radial strength even after 9 mo of hydrolysis, which induces a ∼40% decrease in the poly l-lactide molecular weight (Mn). X-ray microdiffraction evidence of nonuniform hydrolysis in the scaffold reveals that regions subjected to tensile stress during crimping develop a microstructure that provides strength and resists hydrolysis. These beneficial morphological changes occur where they are needed most—where stress is localized when a radial load is placed on the scaffold. We hypothesize that the observed decrease in Mn reflects the majority of the material, which is undeformed during crimping. Thus, the global measures of degradation may be decoupled from the localized, degradation-resistant regions that confer the ability to support the artery for the first several months after implantation.

Long-Term Clinical Outcomes Following Implantation of Bioresorbable Vascular Scaffolds: Experience From Two Australian Centres

2018 ◽  
Vol 27 ◽  
pp. S459-S460
Author(s):  
J. McGrath ◽  
L. Guiney ◽  
J. Li ◽  
D. Vickers ◽  
P. Mikhail ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Vascular Scaffolds ◽  
Bioresorbable Vascular Scaffolds
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