{"id":"61a6c325e7da","type":"article","url":"https://hartvaat.nl/2023/07/18/bioresorbeerbare-coronaire-scaffolds-vijfjaarsuitkomsten-met-verbeterde-techniek/","title":"Bioresorbeerbare coronaire scaffolds: vijfjaarsuitkomsten met verbeterde techniek","title_en":"5-Year Outcomes After Bioresorbable Coronary Scaffolds Implanted With Improved Technique.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2023.05.003","source_url":"https://doi.org/10.1016/j.jacc.2023.05.003","authors":["Gregg W Stone","Dean J Kereiakes","Tommaso Gori","D Christopher Metzger","Bernardo Stein","Matthew Erickson","Jan Torzewski","Ameer Kabour","Guy Piegari","Jeffrey Cavendish","Barry Bertolet","Kelly A Stockelman","Nick E J West","Ori Ben-Yehuda","James W Choi","Steven O Marx","John A Spertus","Stephen G Ellis"],"significance":6,"published":"2023-07-18","source_date":"2023-07-18","image":"","kennis":[],"congress":"","summary_en":"These 5-year data showed that bioresorbable scaffolds implanted with improved technique (proper sizing, high-pressure post-dilation) have better outcomes than earlier experience, though metallic DES remain the standard of care.","created":"2026-07-03T10:30:29Z","updated":"2026-07-03T13:29:32Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Vijfjaarsdata van bioresorbeerbare scaffolds (BVS) met verbeterde implantatietechniek toonden betere uitkomsten dan eerdere ervaringen maar bleven inferieur aan everolimus-eluting stents. BVS hebben de verwachtingen niet waargemaakt.","abstract_original":"BACKGROUND: Bioresorbable vascular scaffolds (BVS) were designed to improve late event-free survival compared with metallic drug-eluting stents. However, initial trials demonstrated worse early outcomes with BVS, in part due to suboptimal technique. In the large-scale, blinded ABSORB IV trial, polymeric everolimus-eluting BVS implanted with improved technique demonstrated noninferior 1-year outcomes compared with cobalt chromium everolimus-eluting stents (CoCr-EES). OBJECTIVES: This study sought to evaluate the long-term outcomes from the ABSORB IV trial. METHODS: We randomized 2,604 patients at 147 sites with stable or acute coronary syndromes to BVS with improved technique vs CoCr-EES. Patients, clinical assessors, and event adjudicators were blinded to randomization. Five-year follow-up was completed. RESULTS: Target lesion failure at 5 years occurred in 216 (17.5%) patients assigned to BVS and 180 (14.5%) patients assigned to CoCr-EES (P = 0.03). Device thrombosis within 5 years occurred in 21 (1.7%) BVS and 13 (1.1%) CoCr-EES patients (P = 0.15). Event rates were slightly greater with BVS than CoCr-EES through 3-year follow-up and were similar between 3 and 5 years. Angina, also centrally adjudicated, recurred within 5 years in 659 patients (cumulative rate 53.0%) assigned to BVS and 674 (53.3%) patients assigned to CoCr-EES (P = 0.63). CONCLUSIONS: In this large-scale, blinded randomized trial, despite the improved implantation technique, the absolute 5-year rate of target lesion failure was 3% greater after BVS compared with CoCr-EES. The risk period for increased events was limited to 3 years, the time point of complete scaffold bioresorption; event rates were similar thereafter. Angina recurrence after intervention was frequent during 5-year follow-up but was comparable with both devices.(Absorb IV Randomized Controlled Trial; NCT02173379)."}