Bioresorbable scaffold—the holy grail of percutaneous coronary intervention: fact or myth?

When Grüntzig preformed the first balloon angioplasty in 1977 (1), it revolutionized the treatment of obstructive coronary artery disease (CAD) and provided an alternative to coronary bypass surgery. While a reasonable procedural and clinical outcome was achievable with balloon angioplasty alone, sustained arterial patency was ultimately undermined by elastic recoil, acute secondary closure and constrictive remodeling (2). The second technological leap in percutaneous coronary intervention (PCI) occurred with the advent of bare metal stents (BMS), which promised to overcome these issues by providing a mechanical scaffold within the coronary arteries (3). Longitudinal studies however have since demonstrated suboptimal long term outcomes with the use of BMS due primarily to the high incidence of in-stent restenosis (ISR) (4).