Letter by Kounis et al Regarding Article, “Long-Term Efficacy and Safety of Everolimus-Eluting Bioresorbable Vascular Scaffolds Versus Everolimus-Eluting Metallic Stents: A Meta-Analysis of Randomized Trials”
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To the Editor:
This significant meta-analysis1 of 6 high-quality randomized trials reporting clinical outcomes beyond 1 year and comparing everolimus-eluting bioresorbable vascular scaffolds with everolimus-eluting metallic stents in 5392 patients demonstrated that the risk of definite or probable stent/scaffold thrombosis and very late stent/scaffold thrombosis was higher with bioresorbable vascular scaffolds. Specifically, the definite or probable stent/scaffold thrombosis was estimated in the range of 2.1% and 0.8% and very late stent/scaffold thrombosis between 0.8% and 0.2%, respectively, based on DerSimonian–Laird and Peto methods. The authors speculate that this difference could be attributed to the potential malposition, late discontinuity, peristrut low-intensity area, uncovered strut, underdeployment, incomplete lesion coverage, recoil, restenosis, strut …