Impact of Bioresorbable Scaffold Use on Procedural Features Compared with New-Generation Drug-Eluting Stents

Abstract

Introduction: Although bioresorbable scaffolds (BRS) are considered a new paradigm in stent technology, operators are often discouraged from implanting BRS because of increased strut thickness, reduced radial force, requirement for pre- and postdilatation of the lesions, and concerns about the risk of stent thrombosis. We compared procedure and fluoroscopy duration, cumulative radiation dose, and contrast agent volume among patients undergoing BRS or drug-eluting stent (DES) implantation. Patients and Methods: One hundred thirty-four patients with a total of 165 coronary lesions, including 64 patients (78 lesions) with BRS and 70 patients (87 lesions) with DES, were selected. Clinical and procedural characteristics and angiographic features were calculated. Procedure and fluoroscopy time, volume of contrast medium, and cumulative radiation dose (Gy) were compared. Results: The number of predilated and postdilated lesions was higher in the BRS group than in the DES group, although baseline lesion morphologies were similar. Stent diameters were comparable between the two groups. Larger postdilatation balloon sizes were chosen in the BRS group. Mean procedure time (45.4 ± 16.1 minutes vs. 38.3 ± 15.1 minutes; p= 0.010), volume of contrast medium (207.7 ± 80.7 mL vs. 154.7 ± 74.6 mL; p= 0.001), fluoroscopy duration (15.9 ± 6.6 minutes vs. 13.1 ± 6.6 minutes; p= 0.014), and radiation dose (1.80 ± 1.08 Gy vs. 1.44 ± 0.91 Gy, p= 0.037) were significantly higher in the BRS group than in the DES group. Conclusion: BRS implantation leads to prolonged fluoroscopy, longer procedure duration, greater contrast volume, and higher radiation exposure compared with DES procedures.