ABSTRACT
This chapter summarizes current insights from late and very late metallic stent thrombosis, gives basic insights into bioresorbable vascular scaffolds (BVSs) healing, and reviews current experience on bioresorbable scaffolds (BRSs) thrombosis. It suggests potential mechanisms and preventive measures for this complication. Several factors have been implicated in the pathogenesis of stent thrombosis, including patient-related factors, lesion factors, procedural factors and device-related factors. In the case of the ABSORB BVSs, its increased strut thickness has been suggested as a potential factor associated with increased thrombogenicity. The presence of underexpansion or excessive strut protrusion into the lumen, which are factors that potentially affect flow conditions, could comprise an adverse environment associated with higher risk for scaffold thrombosis. The introduction of bioresorbable scaffolds has held promise for a reduction of late and very late scaffold thrombosis, as the devices are associated with a favorable healing response, while the vascular morphology can be restored after resorption with elimination of the permanent vessel caging.
