Controversies in Interventional Cardiology
Dual antiplatelet therapy, drug-eluting stents and bioresorbable vascular scaffolds: Evolutionary perspectives
Felipe N. Albuquerque MD,
Anna Bortnick MD, PhD,
Javaid Iqbal MRCP, PhD,
Yuki Ishibashi MD, PhD,
Gregg W. Stone MD,
Patrick W. Serruys MD, PhD,
Felipe N. Albuquerque MD
Division of Cardiovascular Diseases—Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
Search for more papers by this authorAnna Bortnick MD, PhD
Division of Cardiovascular Diseases—Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
Search for more papers by this authorJavaid Iqbal MRCP, PhD
ThoraxCenter, Erasmus University Medical Center, Rotterdam, The Netherlands
Search for more papers by this authorYuki Ishibashi MD, PhD
ThoraxCenter, Erasmus University Medical Center, Rotterdam, The Netherlands
Search for more papers by this authorGregg W. Stone MD
Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York
Search for more papers by this authorCorresponding Author
Patrick W. Serruys MD, PhD
ThoraxCenter, Erasmus University Medical Center, Rotterdam, The Netherlands
Correspondence to: P.W. Serruys, MD, PhD, Erasmus MC, Rotterdam, The Netherlands or International Centre for Circulatory Health, NHLI, Imperial College London, London, UK or Room BD416, Dr. Molewaterplein 40, Rotterdam 3015, Netherlands. E-mail: [email protected]Search for more papers by this authorFelipe N. Albuquerque MD,
Anna Bortnick MD, PhD,
Javaid Iqbal MRCP, PhD,
Yuki Ishibashi MD, PhD,
Gregg W. Stone MD,
Patrick W. Serruys MD, PhD,
Felipe N. Albuquerque MD
Division of Cardiovascular Diseases—Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
Search for more papers by this authorAnna Bortnick MD, PhD
Division of Cardiovascular Diseases—Montefiore Medical Center, Albert Einstein College of Medicine, New York, New York
Search for more papers by this authorJavaid Iqbal MRCP, PhD
ThoraxCenter, Erasmus University Medical Center, Rotterdam, The Netherlands
Search for more papers by this authorYuki Ishibashi MD, PhD
ThoraxCenter, Erasmus University Medical Center, Rotterdam, The Netherlands
Search for more papers by this authorGregg W. Stone MD
Columbia University Medical Center/New York-Presbyterian Hospital, New York, New York
Search for more papers by this authorCorresponding Author
Patrick W. Serruys MD, PhD
ThoraxCenter, Erasmus University Medical Center, Rotterdam, The Netherlands
Correspondence to: P.W. Serruys, MD, PhD, Erasmus MC, Rotterdam, The Netherlands or International Centre for Circulatory Health, NHLI, Imperial College London, London, UK or Room BD416, Dr. Molewaterplein 40, Rotterdam 3015, Netherlands. E-mail: [email protected]Search for more papers by this authorThis article was published online on 10 August 2015. An error was subsequently identified. This notice is included in the online and print versions to indicate that both have been corrected [28 September 2015].
Conflict of interest: Nothing to report.
Abstract
Dual antiplatelet therapy reduces the risk of myocardial infarction, stent thrombosis, and cardiovascular mortality after percutaneous coronary intervention, but the optimal duration of therapy remains unclear. Stent thrombosis, one of the most feared complications of coronary intervention, is associated with high mortality and morbidity and is related in part to technical and patient-specific factors. Advances in device technology and better understanding of the pathophysiology of stent thrombosis have reduced the frequency of this devastating complication. Bioresorbable vascular scaffolds possess a number of advantageous features and are currently undergoing active investigation. Bioresorbable vascular scaffolds have been demonstrated to restore physiologic vasomotion, allow for late lumen enlargement, and upon full resorption remove the nidus for very late polymer reactions and resolve concerns of stent malapposition and side branch jailing. Based on the results from recent large-scale randomized trials, the optimal duration of dual antiplatelet therapy may depend on the choice of device type, as well as the individual patient risk of ischemic versus hemorrhagic complications. © 2015 Wiley Periodicals, Inc.
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