ABSTRACT
This chapter provides an overview on acute and subacute bioresorbable scaffolds (BRSs) thrombosis, with a focus on incidence rates, putative mechanisms, prevention, and management strategies. Several meta-analyses have been published after the reporting of most recent trials and registries of ABSORB BRSs versus everolimus eluting stents (EESs). Mechanisms of scaffold thrombosis are likely multifactorial, stemming from patient- to lesion-specific considerations, along with procedural- and device-related factors that may play a prominent role in the incidence of acute and subacute events. A general rule of common sense to prevent early thrombotic events is to avoid implanting a BRSs in lesions where suboptimal results and loss of scaffold integrity can be anticipated. Prevention of procedural causes with extensive use of best implantation practice, intravascular imaging and adoption of optimal antithrombotic therapies remains essential. When early scaffold thrombosis occurs, understanding and removing the underlying mechanism is the principal condition to avoid recurrences.
