Can Long-Term Results Following Balloon Angioplasty Be the “Crystal Ball” to Predict Outcome Following Bioresorbable Vascular Scaffolds?

I n this issue, Yamaji et al 1 report the very long-term (15-year) outcomes of patients treated successfully with balloon angioplasty (BA) compared with bare-metal stent implantation (BMS). Considering the major progresses made in interventional cardiology since the advent of BA, it would be reasonable to question what relevance these data have in the era of thirdand fourth-generation drug-eluting stents (DESs) that have biodegradable polymers or are polymer free or have a completely bioabsorbable platform. This report comes at an opportune moment in interventional cardiology because of the emergence and availability of the ABSORB everolimus-eluting bioresorbable vascular scaffold (BVS; Abbott Vascular, Santa Clara, CA). These data might be our “crystal ball” into predicting late and very late events after nonpermanent stent alternatives such as drug-eluting balloons (DEBs) or BVS (the BA group) or after implantation of a DES with biodegradable or no polymers (the BMS group). In the current study, Yamaji et al report the very long-term outcomes of patients who were free from early restenosis. The main findings were the following: