Bioresorbable Vascular Scaffold in patients with complex lesions

Bioresorbable vascular scaffolds were designed to overcome the remaining issues of current generation drug-eluting stents (DES) in the treatment of coronary artery lesions: most importantly late in-stent restenosis and neoatherosclerosis leading to (very) late stent thrombosis. The concept of bioresorbable scaffolds is to provide temporary vessel wall support and to allow the vessel wall to heal without leaving a permanent implant behind. This thesis addresses the clinical performance of the Absorb BVS, one of the bioresorbable scaffolds, in an all-comer patient population with complex coronary artery disease. Furthermore, it investigates potential causes of adverse outcomes after the use of the Absorb. This thesis has demonstrated that the use of the Absorb scaffold is associated with an increased risk of device thrombosis as compared to DES. This finding is observed in both a single arm cohort study as in an randomized controlled trial. Furthermore, this thesis has demonstrated that this adverse outcome might be device related rather than related to implantation techniques used by interventional cardiologists.