Abstract 4344222: All Magnesium-Based Bioresorbable Scaffolds in patients with CAD: A Proportional Meta Analysis

Abstract

Background: Coronary artery disease (CAD) is often managed through percutaneous coronary intervention with stent implantation to restore and maintain vessel patency. Metallic stents, such as bare-metal stents and drug-eluting stents (DES), function by mechanically propping open the narrowed artery, preventing acute vessel closure. However, their permanent presence in the vessel wall can lead to long-term complications. Magnesium-based bioresorbable scaffolds have been developed as a temporary support that provide initial vessel reinforcements but gradually degrade and absorbed in the body over time. Methods: This meta-analysis followed PRISMA guidelines and was registered under PROSPERO ID: 1018671. A comprehensive search conducted through Pubmed, Cochrane and Scopus for studies to get primary outcomes as cardiac death, Target vessel myocardial infarction (TVMI), Device-Oriented Composite Endpoint (DOCE), Target lesion failure, t-target lesion revascularization and CD-target lesion revascularization (T-TLR&CD-TLR); secondary outcomes included scaffold thrombosis, restenosis, change in balloon diameter and procedural success. Results: This proportional meta-analysis followed PRISMA guidelines and included 16 studies (4 RCTs, 12 observational) up to 2025. Pooled analysis demonstrated a cardiac death rate of 0% (95% CI: 0.00-0.00) and a (TVMI) rate of 1% (95% CI: 0.01-0.02). (TLF) occurred in 6% of cases (95% CI: 0.06-0.07), while device-oriented composite endpoint (DOCE) was observed in 9% (95% CI: 0.03-0.14). Total target lesion revascularization (TLR) and clinically driven TLR (CD-TLR) were 7% (95% CI: 0.04-0.09) and 5% (95% CI: 0.03-0.06). Scaffold thrombosis was consistently 0% at 6, 12, and 24 months. Restenosis was reported in 8% of patients (95% CI: 0.04-0.12), while procedural success was exceptionally high at 99% (95% CI: 0.99-1.00). The average increase in balloon diameter was 0.43 mm (95% CI: 0.27-0.59). Conclusion: The meta-analysis showed favorable safety outcomes, consistent with previous DREAMS trials. Unlike earlier bioresorbable scaffolds like ABSORB, which had higher thrombosis rates, Mg-BRS showed 0% scaffold thrombosis and low revascularization needs, indicating improved degradation and endothelial healing. While Mg-BRS may outperform (DES) in some cases, study heterogeneity and limited long-term data require cautious interpretation. Future randomized trials, especially in high-risk groups, are needed to validate these findings.