A new generation of drug-eluting stents: Indications and outcomes of bioresorbable vascular scaffolds

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Figure 1
Optical coherence tomographic images show difference in arteries 5 years after implantation of metallic drug-eluting stent (A) and bioresorbable drug-eluting stent (B). Arrows (A) point to remaining stent. In contrast, the bioresorbable stent (B) was completely absorbed.

TABLE 1

Evolution of drug-eluting stents

First generation

Nonbiodegradable (ie, durable) polymer-based thick strut
Sirolimus- or paclitaxel-eluting stents

Second generation
Nonbiodegradable (ie, durable) polymer-based thin strut
“Limus”-eluting stent (eliminated paclitaxel)

Third generation
Biodegradable polymer-based thick or thin strut
“Limus”-eluting stent

Third generation “B”

Polymer-free strut
“Limus”-eluting stents

Fourth generation

Bioresorbable, thick/thin strut
“Limus”-eluting vascular scaffolds (PLLA or magnesium)

“Limus” drugs: biolimus, everolimus, myolimus, novolimus, sirolimus, zotarolimus.
PLLA = poly-L-lactic acid

TABLE 2

Bioresorbable vascular scaffolds

Name (Marketer)	Strut thickness (μm)	Scaffold	Drug
First generation
ReZolve (REVA)	228	PolyCarb	SES
ART 18AZ (ART)	170	PDLLA	None
Absorb BVS 1.1 (Abbott)	156	PLLA	EES
Fortitude (Amaranth)	150	PLLA	SES
DeSolve (ELIXIR)	150	PLLA	NES
Magmaris (Biotronik)	150, 120	Mg, PLLA	SES
Second generation
Fantom (REVA)	125	PolyCarb	SES
Mirage (Manli Cardiology)	125	PLLA	SES
Aptitude (Amaranth Medical)	120	PLLA	SES
DESolve Cx (ELIXIR)	120	PLLA	NES
RENUVIA (Boston Scientific)	≤99

ART = Arterial Remodeling Technologies; EES = everolimus-eluting stent; NES = novolimus-eluting stent; PDLLA = poly-DL-lactic acid; PLLA = poly-L-lactic acid; PolyCarb = poly-tyrosine-derived polycarbonate; SES = sirolimus-eluting stent