Bioabsorbable coronary stents

An ideal stent should furnish best acute outcomes after PCI by sealing intimal flaps and optimizing lumen size. It should control restenosis by limiting negative remodeling and by controlling excessive healing by delivery of an antiproliferative drug. Beyond 6 months, a permanent implant has no useful function and has possible disadvantages including the potential for late thrombosis. The concept of a stent that does its job and disappears has appeal.44 A number of different materials ranging from magnesium to a variety of polymers have been used to construct stents of different designs. Some of these are being tested in clinical trials. The best outcomes to date have been with the BVS everolimus-eluting PLLA stent where in the Absorb trial, cohort A at 2 years, the stent was safe in the small number of patients with simple lesions.9,11 Indeed, there is a suggestion of luminal enlargement between 6 months and 2 years, return of vasomotion, and endothelial function. These findings need to be confirmed in larger trials in more complex lesions. A hope is that a healed, normally functioning vessel free of foreign body and restenosis will be free of the risk of late thrombosis. Time will tell if this dream will come true.

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