CRT-100.86 Long-term Safety of Bioresorbable Scaffolds: Insights From a Network Meta-analysis Including 91 Trials

Abstract

BACKGROUND This study was aimed at investigating the long-term safety and efficacy of the Absorb Bioresorbable Vascular ScaffoldTM (BVS), drug-eluting stents (DES), and bare metal stents (BMS). METHODS Randomized controlled trials that compared 2 or more coronary stents or scaffolds and reported long-term clinical outcomes were included. Electronic search was done in PubMed, Embase, Cochrane Central Register of Controlled Trials, and relevant websites. RESULTS A total of 91 randomized controlled trials that compared 2 or more coronary stents or scaffolds and reported long-term clinical outcomes (>=2 years) comprising 105,842 patients were analyzed (mean follow-up, 3.7 years). Network meta-analysis showed that BVS had a significantly higher risk of definite or probable stent thrombosis (ST) than contemporary DES. The risk of very late ST was highest with the Absorb BVS among comparators. Pairwise conventional metaanalysis showed the elevated risk of ST with BVS compared to cobalt chromium everolimus-eluting stent was consistent across onset time such as early ( 1 year) period. Furthermore, significantly higher risk of target lesion failure was observed with BVS, which was driven by both increased risk of target-vessel-myocardial infarction and ischemia-driven target-lesion revascularization. CONCLUSIONS Implantation of Absorb BVS was associated with increased risk of long-term and very late ST compared to currentgeneration metallic DES, and the risk of scaffold thrombosis appeared to have a rising trend beyond 1 year. (Figure Presented).