FELLOWS’ CORNER
endpoints of recurrent angina at one year and a combined endpoint of target-lesion failure between 1 and 5
years (in which analysis the subjects from ABSORB III
will be included); the early and medium-term safety of
the scaffold will continue to be an question of interest
as more experience increases with the delivery system
and a more varied patient population.
Importantly, BVS have promising uses in specific
sub-populations, including cardiac transplant recipients, patients with radiation-induced coronary disease,
peripheral interventions, spontaneous coronary artery
dissections, and congenital heart disease patients. Both
cardiac allograft vasculopathy and radiation appear to
cause constrictive remodeling of the coronaries, and
both populations are generally young, tend to have
simple lesions and face the need for re-interventioncharacteristics which make them particularly wellsuited for BVS; a randomized trial of the Absorb BVS
is under way in patients post-cardiac transplant.16 The
increased stent flexibility seen in BVS is of interest
in peripheral interventions, in particular in segments
with vessel deformation such as the superficial femoral
artery a nd the popliteal artery behind the knee.17 A
novel application for BVS is in the treatment of large
vessel stenosis in infants and small children, particu-
larly useful in view of the growth of the child and need
for re-intervention. Successful use of BVS has been
reported in branch pulmonary artery stenosis,18, 19
Blalock-Taussig shunt thrombosis, coronary stenosis,
and in coarctation of the aorta.20, 21
This innovation in the field of interventional
cardiology holds promises in both prevalent coronary
disease and niche populations in which it serves an
unmet need, and further data is needed on its safety
and risk-benefit profile. ■
Ada C. Stefanescu Schmidt is a Fellow-in-Training at the
Massachusetts General Hospital in Boston, MA. She is doing outcomes research in interventional cardiology at the
Brigham and Women’s Hospital, and is interested in adult
congenital heart disease.
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