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The Absorb bioresorbable scaffold (BRS) can potentially increase thrombogenicity, being of relatively large strut thickness and width, a team of cardiologists has found.

With a , the Absorb bioresorbable scaffold measures almost twice as thick as a second-generation Xience stent at 81.3 µm. The Absorb bioresorbable scaffold also has a markedly larger strut width, at 190.5 µm for 2.5- and 3.0-mm models, when compared to that of the Xience stent, at 81.3 µm, according to , of EMO-GVM Centro Cuore Columbus, and colleagues.

"Stent design has long been a compromise between strut thickness and radial strength," they wrote in a letter to the editor in JACC: Cardiovascular Interventions. Making that compromise is no easy task, given that narrow struts are less likely to confer restenosis and thrombogenicity, while thick struts give better strength and plaque coverage, they explained.

"Given the increased strut thickness and width of the current BRS, concerns exist regarding appropriate scaffold sizing, which will affect scaffold/artery ratio," they wrote.

At the same time, the authors acknowledged that it may very well be possible that the increased radial strength and lesion coverage of the large BRS "may prevent restenosis and plaque prolapse."

While clinicians await a second-generation Absorb bioresorbable scaffold with a smaller footprint, Colombo and colleagues recommended that operators use care during bioresorbable scaffold sizing.

"Proper sizing of BRS by intravascular ultrasound or optical coherence tomography (or quantitative coronary angiography) is strongly recommended in order to limit excessive scaffold/artery ratio," they concluded.

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