The purpose of designing biodegradable stents is to resolve problems including both early intimal hyperplasia of BMS and late in-stent thrombosis of DES. How wide is the gap between the dream of solving all these problems and the present reality?
<International Circulation>: What is your view of the approach of using a biodegradable polymer coating only?
Dr Buchbinder: The reason that a biodegradable stent could be better is the fact that you are still left with a bare metal stent in the artery and therefore the endothelial function at that spot is not normal. It is endothelialized but it is not functioning as well as it would with a normal non-metallic stented segment. I think there will be an evolution and we will try to understand how to adjust dual antiplatelet therapy duration, how to withdraw antiplatelet therapy, etc. The next phase will be biodegradable polymers that perhaps can obviate the need for very strict dual antiplatelet therapy. Thirdly, once data from fully biodegradable stents is released then we can call the fully biodegradable stents third generation stents. Third generation stents by design are thicker and not as nimble and may not necessarily be used in every lesion. We will probably be using a hybrid approach.