Long-term safety of bioresorbable scaffolds: insights from a network meta-analysis including 91 trials

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#absorbable-implants #coronary-artery-disease #coronary-thrombosis #humans #metals

Long-term safety of bioresorbable scaffolds: insights from a network meta-analysis including 91 trials

Kang et al., 2018 | EuroIntervention | Systematic Review

Citation

Kang Si-Hyuck, Gogas Bill D, ... Kim Hyo-Soo. Long-term safety of bioresorbable scaffolds: insights from a network meta-analysis including 91 trials. EuroIntervention. 2018-Mar-20;13(16):1904-1913. doi:10.4244/EIJ-D-17-00646

Abstract

AIMS: The aim of this study was to investigate the long-term safety and efficacy of biodegradable scaffolds and metallic stents. METHODS AND RESULTS: We analysed a total of 91 randomised controlled trials with a mean follow-up of 3.7 years in 105,842 patients which compared two or more coronary metallic stents or biodegradable scaffolds and reported the long-term clinical outcomes (≥2 years). Network meta-analysis showed that patients treated with the Absorb bioresorbable vascular scaffold (BVS) had a significantly higher risk of definite or probable scaffold thrombosis (ScT) compared to those treated with metallic DES. The risk of very late ScT was highest with the Absorb BVS among comparators. Pairwise conventional meta-analysis demonstrated that the elevated risk of ScT with Absorb BVS compared to cobalt-chromium everolimus-eluting stents was consistent across the time points of ≤30 days (early), 31 days - 1 year (late) and >1 year (very late) ScT. In addition, target lesion failure rates were significantly higher in the Absorb BVS cohort, driven by both increased risk of target vessel myocardial infarction and ischaemia-driven target lesion revascularisation. CONCLUSIONS: Absorb BVS implantation was associated with increased risk of long-term and very late ScT compared to current-generation metallic DES. The risk of ScT occurred with a rising trend beyond one year.

Key Findings

We analysed a total of 91 randomised controlled trials with a mean follow-up of 3.7 years in 105,842 patients which compared two or more coronary metallic stents or biodegradable scaffolds and reported the long-term clinical outcomes (≥2 years). Network meta-analysis showed that patients treated with the Absorb bioresorbable vascular scaffold (BVS) had a significantly higher risk of definite or probable scaffold thrombosis (ScT) compared to those treated with metallic DES. The risk of very late

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 105842
Age Range See abstract
Condition See abstract

MeSH Terms

  • Absorbable Implants
  • Coronary Artery Disease
  • Coronary Thrombosis
  • Humans
  • Metals
  • Patient Safety
  • Percutaneous Coronary Intervention
  • Prosthesis Design
  • Randomized Controlled Trials as Topic
  • Risk Assessment
  • Risk Factors
  • Stents
  • Time Factors
  • Treatment Outcome

Evidence Classification

  • Level: Systematic Review
  • Publication Types: Journal Article, Systematic Review, Network Meta-Analysis
  • Vertical: chromium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09