D-93 | Combined Atherectomy and Lithotripsy for Heavily Calcified Coronary Lesions: A Multicenter Observational Study

Background: First-generation thicker strut bioresorbable scaffolds (BRS) were associated with unexpected adverse outcomes.Less is known about thinner strut BRS and bio-adaptors compared with drugeluting stent (DES) in patients undergoing percutaneous coronary intervention (PCI).Methods: PubMed, Embase and Cochrane database were searched for randomized controlled trials that compared newer generation bioresorbable scaffold (BRS) and bioadaptors with DES for patients undergoing PCI and reported the outcomes of (1) device oriented composite end (DOCE; cardiovascular death, target vessel myocardial infarction (MI), and ischemia-driven target vessel revascularization (ID-TVR); (2) patient oriented composite end point (POCE; all-cause mortality, all MI, or all revascularization); (3) all-cause mortality; (4) cardiovascular death; (5) ID-TVR and ischemia-driven target lesion revascularization (ID-TLR); and (6) probable or definite stent thrombosis.Heterogeneity was examined with I 2 statistics.Results: We included 5 RCTs with 4232 patients, of whom 2117 (50.02%) underwent BRS or bioadaptor placement.Mean follow-up ranged from 1 to 3 years.ID-TLR (RR 0.63; 95% CI 0.40-0.98;p0.04; figure 1) and ID-TVR (RR 0.68; 95% CI 0.45-1.00;p0.05; figure 2) were significantly less common in patients treated with BRS compared with DES.DOCE (RR 0.82; 95% CI 0.56-1.18;p0.28),POCE (RR 1.05; 95% CI 0.83-1.34;p0.68), all-cause mortality, cardiovascular death and probable or definite stent thrombosis were not significantly different between groups.Conclusions: These findings suggest that newer generation BRS may be a viable option for PCI.