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Drug-eluting stents have been used for treatment of peripheral vascular disease of patients with symptoms refractory to optimal medical therapy. Novel stents using bioresorbable vascular scaffolds (BVS) can overcome the constrictive remodeling and natural endothelial elastic recoil. We aimed to analyze clinical and procedural ouctomes of BVS for treatment of symptomatic PAD.
We searched PubMed and Cochrane for all the clinical data that used BVS for symptomatic PAD. Primary outcomes of interest were amputation and clinically driven target lesion revascularization (TLR). Secondary outcomes included death, bypass surgery, definite or probable stent thrombosis (ST) and pseudoaneurysm. We calculated the number of events for each outcome and reported the percentage as well.
Out of 25 articles, three clinical case-control studies were included. The pooled data provided 79 patients treated with BVS. Mean follow-up was 12 months. Lesions were located mainly in the femoro-popliteal area followed by iliac artery. There was no amputation in any of the patients. There was 8% clinically driven TLR. There was 1 (2%) bypass surgery due to an occlusion on a previous bypass that led to stent thrombosis as well. There were 8 TLRs (5%), 4 ST (5%), and 1 pseudoaneurysm (2%). There were no reported deaths.
This is the first analysis of all available clinical data to evaluate the use of BVS for PAD. BVS is safe and feasible for treating PAD. Lesion size and length might lead to different outcomes. In-deep analysis of different anatomical lesions should be pursued.