Stents: Back to the drawing board

Drug-eluting stents were supposed to be the great way forward in artery health in people with atherosclerosis, the disease where plaque narrows the artery.

Not only did the stents employ the latest technology of releasing small amounts of a drug, they were also more effective than standard stents, according to early trials.

As a result, six million people have been fitted with this new generation stent, which includes the Cypher (sirolimus) and the Taxus (paclitaxel), in the last few years.

But a new study has discovered that they can dramatically increase the risk of death and heart attack through thrombosis.

Two Swiss researchers made the discovery after they carried out a meta-analysis of studies to discover the long-term effects of the drug-eluting stent.

In itself, there’s nothing particular clever about the stent; in fact, it’s a form of micro scaffolding inserted into the artery to keep it propped up.  It can be fitted after angioplasty, where the arteries are unblocked, or it can be inserted into patients for whom angioplasty is not appropriate.

But the standard bare metal or uncoated stent hasn’t been a great success.   In one study in 2002, 26 per cent of patients who had a standard stent fitted still suffered re-stenosis, where the arteries block up again – while not one patient with a drug-eluting stent suffered re-stenosis.

The rest, as they say, is history.

(Source: Proceedings of the World Congress of Cardiology, Barcelona).


E-news broadcast 21 September 2006 No.294 [Subscribe]