Bioresorbable vascular scaffolds in daily clinical practice: is the essential really invisible to the eyes?

SEE PAGE 791 B ioresorbable vascular scaffolds (BVS) boast the unique ability to satisfy the temporary need for mechanical support during initial arterial healing following percutaneous coronary revascularization, obviating the long-term disadvantages of permanent metallic prostheses. Based on the results of the ABSORB trial cohort A (n 1⁄4 30) (1) and cohort B (n 1⁄4 101) (2), the Absorb BVS (Abbott Vascular, Santa Clara, California) was the first such device to obtain CE mark approval and become available for clinical use in Europe. Registry data have demonstrated sustained efficacy of the BVS during 5-year follow-up (3–5), based on multimodality imaging, as well as the presence of unique findings such as restoration of nitrate-induced vasomotion (6) and vessel enlargement (positive remodeling) in the treated segment after 2 to 5 years of scaffold deployment (3). Notably, more than 60,000 patients have been treated worldwide with Absorb in the past 3 years, despite the absence of a single randomized trial comparing these devices with contemporary metallic drug-eluting stents (DES). Recently, the results of 2 randomized trials comparing the Absorb BVS with metallic DES were released. In ABSORB II, Serruys et al. (7) compared the BVS with the everolimus-eluting cobalt-chromium Xience stent. This study had a 2:1 single-masked design and coprimary endpoints of nitrate-induced vasomotion