The Bioresorbable Scaffold

Updated on May 15, 2017

Uncovering the Problem

For over 20 years, the world of interventional cardiology was fascinated by the idea of a bioresorbable scaffold. When we introduced the concept of the temporary stent22. Gaspard Ph, Didier B, Lienhart Y, Frieh JP. Temporary stenting for abrupt closure during coronary angioplasty. Lancet. 1991;337:1226-7. Link in the late 1980s, teams and companies were already working on this topic. It was dangerous to leave any trace of our passage… We used a permanent stent to treat a temporary disease. We knew that balloon restenosis was related to elastic recoil (for 20%) and negative remodeling (for 50%) and that these were effectively tackled by stent scaffolding. The remaining challenge was intimal proliferation (for 30%), which was enhanced by stent implantation. The first two mechanisms occurred between nine and 120 days. After that, the continued presence of an intra-coronary device was not ideal, as it was potentially damaging, due to the fact it caused chronic inflammation and delayed healing (consequence of antiproliferative agents) and was accompanied by the risk of late thrombosis. We did not know exactly when we could stop dual antiplatelet therapy. Therefore, the idea of a temporary stent resurfaced –this time one that would...

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