Bioresorbable stents offer clinical efficacy without permanent presence in infrapopliteal arteries

Atman Shah (Chicago, USA) talks to BLearning Peripheral at LINC 2020 (Leipzig Interventional Course; 28–31 January 2020, Leipzig, Germany) about the data he presented at the meeting on the safety and efficacy of bioresorbable stents in patients who have threatened limb-loss or severe claudication and have severe infrapopliteal arterial disease.

There are a “variety of ways” to treat this patient population, says Shah, who notes that, in a retrospective study of 31 such patients, 27 were found to be free of any cardiovascular events. There was no death, no amputation, as well as no bleeding or stent thrombosis at two years. This follows the one-year study results where freedom from clinically-driven target vessel failure was 95.1%.

Shah outlines some of the advantages of bioresorbable scaffolds compared to metal stents and says it is “very provocative and exciting” to think that there is a stent that has the same type of scaffold rigidity, that can elute a drug, but where that metal is completely gone after six to nine months. 

He also touches on the debate around how long a scaffold is needed to remain within an artery, noting that after a year it is “unlikely” for the vessel to mechanically recoil itself. Shah concludes by comparing bioresorbable devices and drug-coated balloons that leave nothing behind. He says that there is “a lot of controversy” surrounding paclitaxel and says that using a drug that may increase mortality “gives me cause for concern”. 

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Shah, Atman

Atman Shah is an interventional cardiologist who specialises in utilising minimally invasive, catheter-based techniques. He is currently the co-director of the Cardiac Catheterisation Laboratory at the University of Chicago as well as the clinical director for the Section of Cardiology in its Department of Medicine.

Shah completed his training at the University of Illinois in 1999 and has also been the recipient of several honours and awards for clinical service, leadership and teaching.

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