Published online Nov 26, 2025. doi: 10.4330/wjc.v17.i11.109287
Revised: July 2, 2025
Accepted: October 21, 2025
Published online: November 26, 2025
Processing time: 198 Days and 19.8 Hours
Bioresorbable scaffolds (BRS) are a promising alternative to traditional drug-eluting stents (DES) for the treatment of acute coronary syndrome (ACS). They offer the potential for complete resorption, which may reduce long-term complications such as stent thrombosis and late restenosis. However, the safety, compatibility, and long-term outcomes of BRS in patients with intermediate to low-risk ACS have yet to be thoroughly investigated.
To investigate the safety, compatibility, and long-term outcomes of BRS in patients with intermediate to low-risk ACS.
Patients with intermediate to low-risk ACS who underwent percutaneous coronary intervention with either DES or BRS, and were continuously recruited from January 2019 to June 2022 at a single center, were analyzed. Baseline data and clinical follow-up were collected for patients who underwent DES im
A total of 128 patients were included in this study, with an average age of 63 years. Among them, 95 were male (74%). The study involved treatment of 201 blood vessels: 87 (43%) received BRS, and 114 (57%) received DES. A total of 97 patients completed the full 3-year follow-up. During this period, 5 patients (17%) in the observation group and 7 patients (16%) in the control group experienced a major cardiovascular event (DoCE). At the 1-year follow-up, 7 patients (15%) in the observation group and 6 patients (10%) in the control group experienced DoCE, and this difference was statistically significant (P < 0.05). At the 2-year follow-up, there was also a significant difference between the two groups in the number of patients who needed repeat treatment of the target blood vessel (P < 0.05). In the observation group, 18 patients (33%) underwent follow-up coronary angiography. During the follow-up period, one patient in the observation group was found to have re-narrowing in the proximal and middle segments of the left anterior descending artery, possibly due to BRS collapse. Another patient in the observation group developed chronic total occlusion in multiple vessels at the 3-year follow-up and underwent coronary artery bypass grafting.
In low- to intermediate-risk ACS patients, those who got BRS had their first major heart event sooner than those who got DES. BRS is more tissue-friendly, yet over three years both groups had about the same amount of problems - only a few BRS patients still saw the scaffold collapse or the vessel slowly block.
Core Tip: This study aimed to investigate the safety and effectiveness of bioresorbable scaffolds (BRS) compared to drug-eluting stents (DES) in patients with intermediate to low-risk acute coronary syndrome. A total of 128 patients were included in the study, with 87 receiving BRS and 114 receiving DES. The patients were followed up for a maximum of 3 years to assess the occurrence of cardiac events and complications. The results showed that the time to reach the composite endpoint of cardiac events was earlier in the BRS group compared to the DES group, although the final number did not differ significantly. BRS demonstrated better compatibility than DES. These findings suggest that BRS may be a viable alternative to DES in patients with intermediate to low-risk acute coronary syndrome, but further research is needed to address the observed complications.