View Full Chapter Figures Only Tables Only Videos Only Print Get Citation Citation AMA Citation Nguyen E, Shroff D. Nguyen E, Shroff D Nguyen, Evelyn, and Deepti Shroff. "Bioresorbable vascular scaffolds linked to increased risk of adverse events at mid- and long-term." 2 Minute Medicine, 19 October 2015. McGraw-Hill, New York, NY, 2015. AccessMedicine. http://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=394239§ionid=173790199 MLA Citation Nguyen E, Shroff D. Nguyen E, Shroff D Nguyen, Evelyn, and Deepti Shroff.. "Bioresorbable vascular scaffolds linked to increased risk of adverse events at mid- and long-term." 2 Minute Medicine New York, NY: McGraw-Hill, 2015, http://accessmedicine.mhmedical.com/updatesContent.aspx?gbosid=394239§ionid=173790199. Download citation file: RIS (Zotero) EndNote BibTex Medlars ProCite RefWorks Reference Manager Mendeley © Copyright Top Return Clip Autosuggest Results Bioresorbable vascular scaffolds linked to increased risk of adverse events at mid- and long-term by Evelyn Nguyen, Deepti Shroff +Originally published by 2 Minute Medicine® (view original article). Reused on AccessMedicine with permission. +1. In comparison to everolimus-eluting metallic stents (EESs), bioresorbable vascular scaffolds (BVSs) increased the chances for thrombotic events at both mid- and long-term follow-up. +2. Compared to patients with EESs, those with BVSs had a heightened risk (that increased over time) of myocardial infarction, target lesion revascularization (TLR), and target lesion failure (TLF). +Evidence Rating Level: 1 (Excellent) Study Rundown: + +Compared to bare-metal stents, drug-eluting stents decrease the frequency of in-stent stenosis, TLR, and myocardial infarction for people undergoing percutaneous coronary interventions (PCIs). However, there are still concerns that these drug-eluting stents may be associated with late and very late stent thrombosis. BVSs were designed to combat these problems, but recent data suggests that BVSs may be associated with a higher risk of cardiovascular events compared to EESs. This study sought to estimate how often scaffold thrombosis occurred after BVS implantation and to compare everolimus-eluting BVSs with EESs regarding safety and efficacy in adults who had a PCI. Through a systematic review and meta-analysis, researchers found that in comparison to EESs, BVSs increased the chances for thrombotic events, including scaffold or stent thrombosis, at both mid- and long-term follow-up. The authors suggest that to improve clinical outcomes of BVSs, better scaffold-specific techniques and scaffold designs are necessary. +Considering that long-term safety and efficacy data were not clearly established in previous trials, a strength of this study is that it evaluates mid- and long-term follow-up data. Limitations of the study include unclear quality of the observational studies used and that some data were not published. +Click to read the study in Annals of Internal Medicine +Click to read an accompanying editorial in Annals of Internal Medicine +Relevant Reading: Everolimus-eluting bioresorbable vascular scaffolds versus everolimus-eluting metallic stents: a meta-analysis of randomised controlled trials In-Depth [systematic review and meta-analysis]: + +Using PubMed, the Cochrane Library, EMBASE, conference proceedings, and pertinent Web sites, researchers completed a meta-analysis of 7 randomized controlled trials (RCTs) and 38 observational studies that included adults with coronary artery disease who received a BVS or an EES and reported thrombosis or other outcomes such as myocardial infarction, revascularization, or death. At a median follow-up of 1 year and beyond 1 year, the rate of scaffold thrombosis following BVS implantation was 1.8% and 0.8%, respectively. In 7 trials with a direct comparison of BVSs with EESs, there was an increased risk (odds ratio [OR], 3.40 [CI, 2.01 to 5.76]) of scaffold thrombosis with BVSs at 25 months (median follow-up). Compared to patients with EES, those with BVSs had a heightened risk of myocardial infarction (OR, 1.63), TLR (OR, 1.31), and TLF (OR, 1.37). Over time, the odds for these three risk factors all increased. +©2017 2 Minute Medicine, Inc. All rights reserved. No works may be reproduced without expressed written consent from 2 Minute Medicine, Inc. Inquire about licensing here. No article should be construed as medical advice and is not intended as such by the authors or by 2 Minute Medicine, Inc.