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Bioresorbable vascular scaffold (BVS) is demonstrated to be clinical equivalent to drug eluting stents (DES) for the treatment of de-novo coronary artery disease. One of his properties is the thicker struts being completed degraded by 24-36 months. Data reporting clinical outcomes is scarce. We aimed to evaluate the global experience of bifurcating lesion treated with BVS.
We searched Pub Med, Cochrane and Embase for all the clinical data reporting clinical outcomes of bifurcating lesions treated with BVS. We reported number of patients, lesions, sex, type of bifurcation per Medina classification, location of the bifurcation. Clinical outcomes included 30 days mortality, long-term mortality, stroke, AMI, target lesion revascularization (TLR), scaffold thrombosis (ST) and stenting technique. We reported the number in percentage value.
Six studies provided a total of 415 patients and 466 lesions. 76% of these patients were men. LAD and diagonal were the most common site of bifurcating lesions (> 50%). More than half (51%) of the lesions were true bifurcation (101,011,111). There was 0.5% mortality at 30 days and 1.2 % at long-term follow up (1 year). There was no stroke and 1.4% of AMI. TLR rate was 7.4% and ST 1.4%. Stenting techniques included V shaped in 1.8% of the cases, T shape in 6.6%, and culotte in less than 1%.
Our analysis suggests that BVS can safely used for bifurcating lesions with good clinical outcomes. Its unique characteristics of absorption can prevent the side branched jailing as it occurs with DES. Comparison between two devices should be pursued with RCT’s.