Bio-Engineered vs Bare Metal vs Drug-Eluting Stents
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Current Postings (4): Desmond -- we are covering this new field
(for example, this Forum Topic and various references in recent articles,
including our October 4 feature, "Conor
CoStar: New Stents May Be Solution to New Stent Problems"). We
also are in the process of creating an entirely new section on
"Emerging Technologies" which will have much more in depth information on
these new devices. Actually, the TCT conference had a number of meetings
on the new technologies, and they were very well-attended, so the word
is definitely out. Sign
up for our newsletter to get announcements
of new sections, articles, etc. In addition to bio-engineered stents, there
have been quite a number of clinical trials involving bio-degradable
stents, which means that the stent will revert to bare metal stents.
Examples are Conor Medsystem (CE mark approved), Biosensors Int,
Biomatrix (awaiting ce mark), Xtent, Devax, Nobori (from Terumo). I
wish that
your website will highlight more info from these new technologies,
instead of always highlighting Taxus, Cypher, Endeavor, etc. For
example, in the recently concluded TCT conference, hardly any mention
was made
of these new technologies - are they that passive? Are they not
involved in the conference? Suneil, given the controversy of the past
couple months, cardiologists and patients alike are looking to the
next generation of stents to solve some of the problems. There are
several out there in research phases, clinical trials and some, like
the stent your doctor mentioned, have achieved some approvals.
The Genous stent works on a
very interesting concept
-- using a bio-coating on the surface not to suppress the growth of
"scar tissue", which is what drug-eluting stents
do, but rather to attract endothelial progenitor cells (EPC) in the
blood which will result in a natural and fast covering of the
metallic stent. It's a new technology that received CE mark approval
a little
over
a year ago,
and is not yet available in the U.S. The positive side is that patients
would not need to take long-term dual antiplatelet therapy and that
hopefully the issue of late stent thrombosis, a very low-frequency
but potentially
catastrophic
event, would not be an issue. Have any physicians or patients out there
had experience with this or other new devices? Let us know. 2 months back, my CT scan showed a 70% blockage
in the LAD with a potential 50% (soft plaque) blockage in the Left
Main and less than 50% in the right circumflex. We were against an
angioplasty due to the Stent Controversy. With a significant change
in lifestyle, my Cholesterol has recently been lowered to 98 mg with
a HDL:LDL ratio of 1.08. My doctor advises an Angio is necessary
for proper diagnosis - with the intent to do an Angioplasty if the
blockage
is more than 70%. However, if the major blockage involves the Left
Main, a Bypass would be his recommendation. In case a stent is used,
he suggests a bio engineered stent (BES???) called Genous. Marketing
materials suggest this (BES) is a safer and more pragmatic option,
but there is less than 12 months of data available. Is the data available
adequate to form a reasonable opinion? What are their merits vs BMS
vs DES. Are there any other factors we should be aware of with the
use of Bio Engineered Stents? My procedure is being scheduled for
next week. |
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