Three-year outcome of everolimus-eluting bioresorbable vascular scaffold versus everolimus-eluting metallic stents: a comprehensive updated meta-analysis of randomized controlled trials

Expert Rev Med Devices. 2019 May;16(5):421-427. doi: 10.1080/17434440.2019.1610389. Epub 2019 Apr 28.

Abstract

In recent years, everolimus-eluting bioresorbable vascular scaffold stents (EE-BRS) were developed as alternative to everolimus-eluting metallic stents (EES) for coronary artery disease (CAD) treatments. Areas covered: Searches were conducted in MEDLINE, EMBASE, EBSCO, Springer, Ovid, TCTMD, Cardiosource, Clinical Trial Results and the Cochrane Library with combined key words such as bioresorbable vascular scaffold (BVS), everolimus-eluting metallic stents, EES, coronary artery disease, CAD and randomized-Controlled Trials.Finally, 5,474 patients were enrolled for comparison of device-induced thrombosis, ischemia-driven target lesion revascularization (ID-TLR), device-oriented composite endpoints (DOCE), patient-oriented composite endpoints (POCE), and target vessel failure (TVF) between EE-BRS and EES treatments. The primary literature search retrieved 200 records. Expert Opinion: There was no difference regarding DOCEs, POCEs and ID-TLRs for 1 or 2 years, whereas there were significant differences regarding thrombosis between EE-BRS and EES interventions in the 1-year (pooled HR, 2.15, 95%CI: 1.11, 4.18) and 2-year follow-ups (pooled HR, 2.02, 95%CI: 1.08, 3.78), but not in the 3-year follow-up (pooled HR, 1.57, 95%CI: 0.66, 3.75) anymore. The results of this study showed no inferiority of EE-BRS regarding TVF, DOCE, POCE and ID-TLR 1-year and 2-years after interventions, but enhanced risk of thrombosis in the EE-BRS patients, which disappeared in 3-year follow-ups.

Keywords: Ischemia driven target lesion revascularization; bioresorbable stent; device-oriented composite endpoints; everolimus; ischemia; metallic stent; patient-oriented composite endpoints; revascularization.

Publication types

  • Meta-Analysis

MeSH terms

  • Absorbable Implants*
  • Drug-Eluting Stents*
  • Endpoint Determination
  • Everolimus / therapeutic use*
  • Female
  • Follow-Up Studies
  • Humans
  • Randomized Controlled Trials as Topic*
  • Risk Factors
  • Stents*
  • Thrombosis / therapy
  • Tissue Scaffolds / chemistry*
  • Treatment Outcome

Substances

  • Everolimus