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VIDEO: BVS appropriate for normal-sized vessels
CHICAGO — In this video, Gregg Stone, MD, cardiologist at NewYork-Presbyterian Hospital/Columbia University Medical Center, discusses a bioresorbable vascular scaffold (BVS; Absorb, Abbott Vascular), which he said has the potential to improve long-term outcomes and change practice.
The randomized ABSORB 3 trial had previously shown the BVS to be noninferior to a metallic drug-eluting stent (Xience, Abbott Vascular) for the primary endpoint of target lesion failure at 1 year.
However, Stone, a member of the Cardiology Today’s Intervention Editorial Board, said, there have been concerns about scaffold thrombosis with the BVS.
As a result, Stone said, investigators performed an additional analysis and found scaffold thrombosis events clustered in patients who had the BVS implanted in very small vessel diameters, defined as < 2.5 mm by visual estimation. The device was not intended for these vessels, he said.
By contrast, the 81% of patients who had vessel diameter 2.5 mm or larger had similar rates of device thrombosis, TLF and other adverse events regardless of assignment to BVS or DES.
“Recently an FDA advisory panel voted 9-0 that the Absorb is safe and effective for use as indicated, so it's going to be important that we train people not to implant the Absorb scaffold in very small coronary arteries,” Stone concluded.