Bioresorbable Scaffolds (BRS) in Current and Future

Bare metal coronary stents (BMS) were first clinically applied to human coronary artery in 1986 to overcome the inherent limitations of balloon angioplasty (BA), including restenosis and vessel closure in the acute phase. This technology became widely accepted as a promising treatment strategy for patients with coronary artery disease after the landmark Belgian Netherlands Stent trial (BENESTENT), which demonstrated the superiority of the bare metal stent (BMS) over BA in the 1990s. Although coronary stenting improved angiographic results and clinical outcomes, neointimal hyperplasia and restenosis continued to be major limitations of this technology. In order to minimize neointimal hyperplasia and thereby reduce repeat revascularization, drug-eluting stents (DES) entered clinical arena in 1999. However, the concept of using a permanent metallic prosthesis implies major drawbacks, such as the presence of a foreign material within the native coronary artery that causes vascular inflammation and neoatherosclerosis, and also impedes the restoration of the vasomotor function of the stented segment. Bioresorbable scaffolds (BRS) have been introduced to overcome these limitations, since they provide temporary scaffolding and then disappear, liberating the treated vessel from its cage. While several technical and procedural limitations have been reported in the current stage of BRS, such issues will be overcome by the introduction of new technology of the scaffolds.