Bioabsorbable versus permanent stents – what are the long-term clinical benefits?

This study investigated if bioabsorbable polymer (BP) or permanent polymer (PP) drug-eluting stents (DES) are more effective.

They found that BP- and PP-DES are similarly effective.

Coronary artery disease (CAD) is a common and serious condition. It leads to blockages in the coronary arteries that supply blood to the heart. One way to treat CAD is by using a stent. A stent is a medical device that can be used to remove blockages. The stent is implanted using a minimally-invasive technique. This involves a procedure called percutaneous coronary intervention (PCI). Nowadays, most are drug-eluting stents (DES). DES are coated with drugs that help prevent blood from clotting and causing blockages. 

There are two main types of DES. These are bioabsorbable polymer (BP) and permanent polymer (PP) DES. BP-DES naturally degrade over time. PP-DES do not degrade. PP-DES may cause inflammation over time. Short-term studies have found that BP-DES have similar effectiveness to PP-DES. It is unclear if BP-DES as effective as PP-DES long-term. 

This study included 57,487 patients undergoing PCI. The authors compared the outcomes for patients after implantation of BP- or PP-DES. The analysis was performed at 2 years. The main outcome was restenosis (RS). RS is the term for a blockage after stent surgery. Other outcomes included stent thrombosis (clotting, ST). The frequency of heart attacks and death were also compared. 

95,610 stents were implanted. This included 16,504 BP-DES and 79,106 PP-DES. ST rates were 0.48% for BP-DES and 0.68% for PP-DES. The rates of RS were similar in both groups (1.2% -BP vs. 1.4% – PP). Heart attack and mortality rates were low in both groups and not significantly different. 

The authors concluded that BP- and PP-DES are similarly effective.

This was a non-randomized study. The long-term effectiveness of BP- and PP-DES requires more investigation. 

If you have any concerns regarding CAD, please consult with your physician.