Challenges of the newer generation of resorbable magnesium scaffolds: Lessons from failure mechanisms of the past generation.

Bioresorbable scaffolds (BRS) were developed to overcome the obstacles of metallic stents, mostly related to sustained presence of metallic foreign body in the coronary vessel. Following earlier success of single-arm BRS studies, randomized controlled trials of Absorb bioresorbable vascular scaffold (Abbott Vascular, Santa Clara, CA, USA) showed poor long-term clinical outcomes, particularly in terms of scaffold thrombosis. BRS made from magnesium alloy provide a promising alternative in terms of radial force, strut thickness and, potentially lower thrombogenicity. A recent clinical study demonstrated that magnesium-based BRS seems to be promising with regards to the risk of scaffold thrombosis. In this review, our aim is to describe the issues that prevented Absorb BVS from achieving favorable outcomes, provide current status of existing BRS technologies and the challenges that newer generation BRSs need to overcome, and the results of clinical studies for commercially available magnesium-based BRS, which remain the only BRS actively studied in clinical practice.

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Déclaration de conflit d'intérêts

Conflict of interest The other authors report no conflict of interest; M.J. reports personal fees from Orbus Neich, Astra Zeneca, Recor, grants, and personal fees from Biotronik, Boston Scientific, Edwards Lifesciences and grant support from Amgen outside the submitted work.