The State of the Absorb Bioresorbable Scaffold: Consensus From an Expert Panel.

Autor:	Bangalore S; Department of Medicine, New York University School of Medicine, New York, New York. Electronic address: sripalbangalore@gmail.com., Bezerra HG; Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio., Rizik DG; Department of Medicine, HonorHealth and the HonorHealth Heart Group, Scottsdale, Arizona., Armstrong EJ; Department of Medicine, University of Colorado, Denver, Colorado., Samuels B; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, California., Naidu SS; Department of Medicine, Westchester Medical Center, Valhalla, New York., Grines CL; Department of Medicine, North Shore University Hospital, Manhasset, New York., Foster MT; Department of Medicine, Tennova Healthcare, Knoxville, Tennessee., Choi JW; Department of Medicine, Baylor Heart and Vascular Hospital, Dallas, Texas., Bertolet BD; Department of Medicine, North Mississippi Medical Center, Tupelo, Mississippi., Shah AP; Department of Medicine, University of Chicago, Chicago, Illinois., Torguson R; Department of Medicine, MedStar Washington Hospital Center, Washington, DC., Avula SB; Department of Medicine, Advocate Christ Hospital and Medical Center, Oak Lawn, Illinois., Wang JC; Department of Medicine, MedStar Union Memorial Hospital, Baltimore, Maryland., Zidar JP; Department of Medicine, UNC/Rex Healthcare, Raleigh, North Carolina., Maksoud A; Department of Medicine, Cardiovascular Research Institute of Kansas, Kansas City, Kansas., Kalyanasundaram A; Department of Medicine, Seattle Heart and Vascular Institute, Seattle, Washington., Yakubov SJ; Department of Medicine, OhioHealth, Columbus, Ohio., Chehab BM; Department of Medicine, University of Kansas, Kansas City, Kansas., Spaedy AJ; Department of Medicine, Missouri Heart Center, Columbia, Missouri., Potluri SP; Department of Medicine, The Heart Hospital Baylor Plano, Plano, Texas., Caputo RP; Department of Medicine, St. Joseph's/Trinity Hospital, Syracuse, New York., Kondur A; Department of Medicine, DMC Heart Hospital/Wayne State University, Detroit, Michigan., Merritt RF; Department of Medicine, Mercy Hospital and Clinic, Springfield, Missouri., Kaki A; Department of Medicine, Heart & Vascular Institute, Detroit, Michigan., Quesada R; Department of Medicine, Miami Cardiac & Vascular Institute, Baptist Health, Miami, Florida., Parikh MA; Department of Medicine, Columbia University Medical Center, New York, New York., Toma C; Department of Medicine, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania., Matar F; Department of Medicine, University of South Florida, Tampa, Florida., DeGregorio J; Department of Medicine, Englewood Hospital and Medical Center, Englewood, New Jersey., Nicholson W; Department of Medicine, York Hospital, York, Pennsylvania., Batchelor W; Department of Medicine, Tallahassee Memorial Hospital/Florida State University, Tallahassee, Florida., Gollapudi R; Department of Medicine, San Diego Cardiac Center, San Diego, California., Korngold E; Department of Medicine, Providence St. Vincent Medical Center, Portland, Oregon., Sumar R; Department of Medicine, St. Joseph's Hospital and Medical Center, Phoenix, Arizona., Chrysant GS; Department of Medicine, INTEGRIS Baptist Medical Center, Oklahoma City, Oklahoma., Li J; Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio., Gordon JB; Department of Medicine, San Diego Cardiac Center, San Diego, California., Dave RM; Department of Medicine, Geisinger Holy Spirit, Harrisburg, Pennsylvania., Attizzani GF; Department of Medicine, University Hospitals Cleveland Medical Center, Cleveland, Ohio., Stys TP; Department of Medicine, Sanford Health, Sioux Falls, South Dakota., Gigliotti OS; Department of Medicine, Seton Heart Institute, Austin, Texas., Murphy BE; Department of Medicine, Arkansas Heart Hospital, Little Rock, Arkansas., Ellis SG; Department of Medicine, Cleveland Clinic, Cleveland, Ohio., Waksman R; Department of Medicine, MedStar Washington Hospital Center, Washington, DC.
Jazyk:	angličtina
Zdroj:	JACC. Cardiovascular interventions [JACC Cardiovasc Interv] 2017 Dec 11; Vol. 10 (23), pp. 2349-2359.
DOI:	10.1016/j.jcin.2017.09.041
Abstrakt:	Significant progress has been made in the percutaneous coronary intervention technique from the days of balloon angioplasty to modern-day metallic drug-eluting stents (DES). Although metallic stents solve a temporary problem of acute recoil following balloon angioplasty, they leave behind a permanent problem implicated in very late events (in addition to neoatherosclerosis). BRS were developed as a potential solution to this permanent problem, but the promise of these devices has been tempered by clinical trials showing increased risk of safety outcomes, both early and late. This is not too dissimilar to the challenges seen with first-generation DES in which refinement of deployment technique, prolongation of dual antiplatelet therapy, and technical iteration mitigated excess risk of very late stent thrombosis, making DES the treatment of choice for coronary artery disease. This white paper discusses the factors potentially implicated in the excess risks, including the scaffold consideration and deployment technique, and outlines patient and lesion selection, implantation technique, and dual antiplatelet therapy considerations to potentially mitigate this excess risk with the first-generation thick strut Absorb scaffold (Abbott Vascular, Abbott Park, Illinois). It remains to be seen whether these considerations together with technical iterations will ultimately close the gap between scaffolds and metal stents for short-term events while at the same time preserving options for future revascularization once the scaffold bioresorbs. (Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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