Posted on 03/08/2005 4:44:37 PM PST by neverdem
The Associated Press
ORLANDO, Fla. — A new generation of tiny, drug-coated metal scaffolds that prop open arteries has transformed heart care and is allowing a growing number of people to avoid bypass surgery.
The devices, called drug-coated stents, release medication that prevents vessels from reclogging after procedures to open them up.
At an American College of Cardiology conference on Sunday, doctors reported that both brands sold today are equally good at keeping blood flowing smoothly, although one might be better for diabetics. Both were vastly better than the plain metal ones that were standard just a few years ago.
Benefits apparently last for years, and even very big blockages in very small vessels can be fixed this way. The devices work so well that when an older stent clogs, it's better to put a new drug-coated one inside it than to treat the problem with radiation as has been done in the past, one study found.
Older-style stents reclogged about one-fourth of the time until drug-coated ones came along and cut the rate to around 5 percent. The first, Cypher, made by Cordis Corp., a Johnson & Johnson company, went on sale in Europe in 2002 and in the United States a year later. Boston Scientific Corp.'s Taxus stent was approved last year.
On Sunday, results of the first large comparison study showed them to be comparable.
It involved 1,353 patients in Europe, Latin America and Asia. Rates of heart attacks, strokes and repeat procedures were similar with both stents, reported Marie-Claude Morice of Institut Cardiovasculaire Paris Sud in France.
Cordis sponsored the study.
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A quarter of uncoated stents clog up? Ugh. Maybe I'll ask my doc if a coated stent installation is in my future....
So, about this:
Benefits apparently last for years, and even very big blockages in very small vessels can be fixed this way. The devices work so well that when an older stent clogs, it's better to put a new drug-coated one inside it than to treat the problem with radiation as has been done in the past, one study found.Why can't they just remove the old stent?
Also: How long do these medicated stents keep on delivering the drug? How do they do that?
I had my stents (4) (Cypher Sirolimus-eluting Coronary Stent) put in 9-16-2003 under emergency conditions. No problems to date. I too take Plavix and of course 1 full aspirin daily.
You're not alone, I'm taking Plavix, too.
engrpat: How did you find out it was time to get the stent cleared out? Angina?
(Crap, I'm a young man... it sucks to have to worry about my heart health like this! At least I'm back to running (4 miles/day) and skiing a full, hard day!)
You're not alone, I'm taking Plavix, too.
Count me in, and I have the coated stents
Thanks for the replies, guys! It's nice to know there are others out there with this going on.
It may not be as easy as it sounds. I'm not an interventional cardiologist.
Also: How long do these medicated stents keep on delivering the drug? How do they do that?
I've got a "triple A" to deal with. (My own.)Wonder if a stent will be needed when it becomes necessary ?
Was the old stent removed and replaced? Do you remember the name of the procedure? How was it explained to you?
IIRC, they were using goretex grafts for abdominal aortic aneurysms in 1990.
I had to have two stents put in an artery a couple of years ago. Had a stress test some time after that. Seems like everything is okay. I take an occasional aspirin, garlic caps, Vit. C and lecithin capsules which are supposed to help circulation stuff.
I'm not an interventional cardiologist either, but I did stay at a Holiday Inn Express last night.
When a stent is inserted (they call it "deployed"), it is attached to a catheter that is run into your body, typically through the femural artery near your groin. When it is delivered to the right place in an artery near your heart, the "balloon" that is directly underneath the stent is inflated, the metal struts of the stent bend and the stent is expanded until it is tightly pressing against the interior lining of your artery.
If the stent were not tightly adhering to the inner lining, it would scrape and cause damage, including scar tissue, that would increase the likelihood of restenosis, or the closing of the artery after it has been propped open by the stent's scaffolding ability.
In order to remove the stent, it would either have to be (a) collapsed in the artery, then dragged all the way out, or (b) removed during bypass surgery. (a) is not viable, since there is no way to collapse a stent, let alone remove it; and (b) requires an in-patient treatment.
Bypass may be necessary if too many re-stenting procedures are necessary, because the cumulative thickness of the stents will add up and disrupt blood flow.
Thanks for the info.
Yup, the angina returned and I went back to the doctor. Didn't screw around that time and glad I didn't. I have been symptom free now about 6 years.
The old stent was left in and cleaned out. If I remember the procedure was called a angioplasty. I was in the hospital for about 24 hours. He explained that in a certain number of stent procedures the stent may plug up and need to be cleaned out. This was before the new medicated stents that they have now. All I can say is medicine has become a marvel. I was born during WWII and remember when having an appendix removed was the thing to be feared. Look at medicine now.
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