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Contemporary Reviews in Interventional Cardiology

Bioabsorbable Coronary Stents

John A. Ormiston, MBChB and Patrick W.S. Serruys, MD, PhD

From the Mercy Angiography (J.A.O.), Mercy Hospital, Auckland, New Zealand; and Thoraxcenter (P.W.S.S.), Erasmus Medical Center, Rotterdam, The Netherlands.

Correspondence to John A. Ormiston, MBChB, Mercy Angiography, Mercy Hospital, 98 Mountain Road, PO Box 9911, Newmarket, Auckland, New Zealand. E-mail johno@mercyangiography.co.nz

Key Words: stents • restenosis • follow-up studies • remodeling • thrombosis

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Percutaneous coronary intervention (PCI) with bioabsorbable stents has created interest because the need for mechanical support for the healing artery is temporary, and beyond the first few months there are potential disadvantages of a permanent metallic prosthesis. Stents improve immediate outcomes, including profoundly reducing acute vessel occlusion after PCI by scaffolding intimal tissue flaps that have separated from deeper layers and by optimizing vessel caliber. They limit restenosis by preventing negative remodeling.¹ The intimal hyperplastic healing response to PCI that contributes to restenosis, especially after bare metal stenting, can be limited by coating stents with antiproliferative medications.^2,3

Potential advantages of having the stent disappear from the treated site include reduced or abolished late stent thrombosis, improved lesion imaging with computed tomography or magnetic resonance, facilitation of repeat treatments (surgical or percutaneous) to the same site, restoration of vasomotion, and freedom from side-branch obstruction by struts and from strut fracture-induced restenosis. Bioabsorbable stents have a potential pediatric role because they allow vessel growth and do not need eventual surgical removal.² The progression of stenosis seen within stents 7 to 10 years after stenting has been attributed, at least in part, to inflammation around metallic struts, which might argue for an absorbable stent.³ Progression is also observed late after balloon angioplasty.⁴ Some patients say they prefer an effective temporary implant rather than a permanent prosthesis.

Although the concept of bioabsorbable stents has created interest for >20 years, there are challenges in making a stent that has sufficient radial strength for an appropriate . . . [Full Text of this Article]