Bioresorbable scaffold use in the “real world” – mantras from the East

Ashok Seth

The Absorb bioresorbable vascular scaffold (A-BVS) (Abbott Vascular, Santa Clara, CA, USA) represents a significant advance in the treatment of coronary artery disease. In use increasingly around the world, over the last year it has had to its credit three seminal trials (ABSORB China, ABSORB Japan and ABSORB III) which have demonstrated that A-BVS is as good as the best in class second-generation metallic drug-eluting stent (DES) both for safety and effectiveness at one year. These findings have also led to its approval in the USA two months ago. Over the last three years, clinical uptake of this revolutionary therapy has fluctuated between scepticism and optimism, confidence and caution and clarity and confusion – and all this because of the single fact that the A-BVS does not behave like the thin-strut, lowerprofile user-friendly third-generation DES, which makes life so “simple” for the busy interventional cardiologist, even in complex lesions. The dreaded complication of stent thrombosis is also rare for DES as they are “technically forgiving” despite, in many instances, suboptimal implantation. The A-BVS is a “new device” and has a unique set of deployment and implantation characteristics, hence it requires its own set of “tips and tricks” for safe and effective implantation.