ORLANDO, March 6 -- A new generation of tiny, drug-coated metal scaffolds that prop open arteries have transformed heart care in just a few years and are allowing a growing number of people to avoid having bypass surgery.
The devices, called drug-coated stents, slowly release medication that prevents vessels from reclogging after procedures to open them up.
Drug-coated stents emit medication that deters vessels from reclogging.
(Boston Scientific via AP)
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At an American College of Cardiology conference on Sunday, doctors reported that both brands sold today are equally great at keeping blood flowing smoothly, although one might be better for diabetics. Both were vastly better than the plain old metal ones that were standard just a few years ago.
Benefits apparently last for years, and even big blockages in small vessels can be fixed this way. The devices work so well that when an older stent clogs, it is 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.
Competitors also are being developed that could help cut the price of these devices. One novel type even dissolves in the body once its job is done.
"It's looking very good," Gerald Fletcher, a Mayo Clinic cardiologist, said of the evidence for drug-coated stents. "The benefit is going to be substantial in the long term."
Clogged arteries can cause a heart attack. One solution is open-heart bypass surgery, in which blood vessels from elsewhere in the body are used to create detours around blockages.
A less drastic treatment is angioplasty, in which a tiny balloon is snaked through blood vessels to blockages and inflated to flatten them. Nearly a million of these procedures are done each year in the United States, and in most cases a stent is placed to keep the artery from squeezing shut again.
But even these reclogged about one-fourth of the time, until drug-coated ones came along and cut the rate to about 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.
They use radically different drugs, and it had not been known which is better. On Sunday, results of the first large comparison study showed them to be comparable.