Biolimus-eluting stent with biodegradable polymer (Nobori®): an overview of recent clinical results, SORT OUT V and COMPARE II trials

Abstract

Evaluation of: Christiansen E, Jensen L, Thayssen P et al. Biolimus eluting biodegradable polymer coated stent vs durable polymer coated sirolimus eluting stent in unselected patients receiving percutaneous coronary intervention (SORT OUT V): a randomized non inferiority trial. Lancet 381, 661–669 (2013); Smits P, Hofma S, Togni M et al. Abluminal biodegradable polymer biolimus-eluting stent vs durable polymer everolimus eluting stent (COMPARE II): a randomized, controlled, non inferiority trial. Lancet 381, 651–660 (2013).Since their apparition, first generation drug-eluting stents (DESs) have raised concerns regarding the risk of late and very late stent thrombosis as compared to bare metal stents and require prolonged dual antiplatelet therapy. Aside from delayed strut endothelialisation, positive vessel remodelling and late stent mal-apposition due to chronic inflammation may be a leading cause for these stent thromboses. In fact, the persistence of the durable polymer after complete drug release is responsible for local hypersensitivity and inflammatory reactions. Third generation DESs with biocompatible or biodegradable polymer have subsequently been developed to address this issue. In this article, we evaluate and discuss the results of two recent publications investigating safety and efficacy of a third generation DES with biodegradable polymer as compared to first and second generation DESs with durable polymer.