ABSTRACT
Bioresorbable scaffolds (BRSs) represent one of the most promising innovations in the field of coronary intervention. Specific approaches and modified techniques should be considered taking into account the physical properties of current BRSs. BRS fractures are a real concern when treating bifurcations: this phenomenon is not apparent at angiography. Optical coherence tomography (OCT) may be preferred over intravascular ultrasound (IVUS) because of higher resolution and the ability to identify struts more precisely. The provisional approach remains the default strategy. However, when a 2-scaffold strategy is necessary, upfront T-stenting or T and small protrusion (TAP) can be performed. BRSs are structurally different compared to conventional metallic drug eluting stents (DESs). Scaffold optimization with intravascular imaging and appropriate antithrombotic therapy might reduce the risk of early scaffold thrombosis, and therefore is almost mandatory. However, larger studies with longer follow-up are needed for BRS to be routinely recommended in the treatment of bifurcation lesions.
