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Doctors Excited by 'Breakthrough' Heart Stent


"At the moment, many patients are still treated with medicines, unless they have a [significant artery] blockage. Now, if you have a safe device that really works -- the effectiveness of angioplasty is now over 90% -- [fewer] patients will go to surgery," Morice said.

With simple angioplasty, a balloon at the end of a long tube is threaded through an artery in the groin. The doctor shimmies the probe up through the patient's leg and right into the arteries of the heart, inflating the tiny balloon at the spot where the vessel has narrowed. The balloon cracks open the plaque and stretches the walls of the vessel. Then the balloon is deflated and removed. In about 25% or 30% of patients, the arteries close up again.

To keep the vessel open, doctors often add a stent to the end of the balloon catheter. Stents bring the rate of renarrowing down to about 15% to 25% of cases.

It happens because the blood vessel wall is injured when the stent is implanted. The area then becomes inflamed and new cells start to grow to form scar tissue. The attempt to heal the wound becomes exaggerated and the artery walls become so thick that it sometimes protrudes into the inside of the mesh scaffold. This tends to happen within six months of the stent being implanted.

Doctors then have to stretch the blood vessel again, put a new stent inside the existing one, or perform bypass surgery.

The new stent is coated with Rapamune, usually used to prevent organ rejection in kidney transplants. It stops new cells forming without impairing the proper healing of the vessel, dampens inflammation, and also has antibiotic properties.

The stent releases the drug, generically known as sirolimus or rapamycin, over 45 days.

Johnson & Johnson, which developed the stent, said it expects the device to be on the market in Europe next year and in the U.S. in 2003. The study was sponsored by the company.

This past spring, doctors have shown they can use radiation to treat restenosis around stents. In fact, doctors had been so optimistic about the procedure that they told WebMD that most cardiologists will be using radiation to treat restenosis and prevent a recurrence.

The advantage of using this new stent, if it proves successful, is that the initial renarrowing could be prevented and not even require the radiation treatment.


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