Bioresorbable stent implantation to treat coronary artery disease

NICE did a rapid review of the published literature on the efficacy and safety of this procedure. This comprised a comprehensive literature search and detailed review of the evidence from 13 sources, which was discussed by the committee. The evidence included 1 health technology assessment, 2 randomised controlled trials, 3 systematic reviews with meta-analysis, 5 case series and 2 case reports. It is presented in the summary of key evidence section in the interventional procedures overview. Other relevant literature is in the appendix of the overview.

The professional experts and the committee considered the key efficacy outcomes to be: reduced coronary insufficiency symptoms, maintenance of coronary patency, a reduced myocardial infarction rate and reduced mortality.

The professional experts and the committee considered the key safety outcomes to be: death, myocardial infarction, in-stent thrombosis and need for further intervention.

Patient commentary was sought but none was received.

The committee noted that most of the evidence came from a single device, which has now been withdrawn from the market. This device was associated with an increased risk of complications in the longer term, including myocardial infarction and death.

The committee was informed that:

• the rate of stent bioresorption varies between people who have had a stent implanted and also between different types of device

• there are new generation devices being developed.