Heart and Vascula...
Follow
Find tag "angiopasty"
27.5K views | +1 today
Heart and Vascular Health
Media, News & Topics on prevention, diagnosis & treatment of cardiovascular disease
Your new post is loading...
Your new post is loading...
Scooped by Seth Bilazarian, MD
Scoop.it!

10 years ago the first drug eluting stent data published: Sirolimus-Eluting Cypher Stent in Sirius Trial

10 years ago the first drug eluting stent data published: Sirolimus-Eluting Cypher Stent in Sirius Trial | Heart and Vascular Health | Scoop.it

Randomized, double-blind trial comparing a sirolimus-eluting stent with a standard stent in 1058 patients at 53 centers in the United States who had a newly diagnosed lesion in a native coronary artery. The coronary disease in these patients was complex because of the frequent presence of diabetes (in 26 percent of patients), the high percentage of patients with longer lesions (mean, 14.4 mm), and small vessels (mean, 2.80 mm). The primary end point was failure of the target vessel (a composite of death from cardiac causes, myocardial infarction, and repeated percutaneous or surgical revascularization of the target vessel) within 270 days.

Results The rate of failure of the target vessel was reduced from 21.0 percent with a standard stent to 8.6 percent with a sirolimus-eluting stent (P<0.001) — a reduction that was driven largely by a decrease in the frequency of the need for revascularization of the target lesion (16.6 percent in the standard-stent group vs. 4.1 percent in the sirolimus-stent group, P<0.001). The frequency of neointimal hyperplasia within the stent was also decreased in the group that received sirolimus-eluting stents, as assessed by both angiography and intravascular ultrasonography. Subgroup analyses revealed a reduction in the rates of angiographic restenosis and target-lesion revascularization in all subgroups examined.

Conclusions

In this randomized clinical trial involving patients with complex coronary lesions, the use of a sirolimus-eluting stent had a consistent treatment effect, reducing the rates of restenosis and associated clinical events in all subgroups analyzed.

Seth Bilazarian, MD's insight:

10 years ago the coronary interventional world was revolutionized with the publication and availability of the first drug eluting stent (DES) for coronary artery disease treated with angioplasty. We have several newer versions since and this first version is no longer available and the company that manufactured it ($JNJ) has exited the business.
This innovation has made the minimally invasive treatment of coronary artery disease more durable since the chance of re-narrowing at the site of the stent is less than 10%..

more...
Scooped by Seth Bilazarian, MD
Scoop.it!

The passion for procedures to fix ailing arteries and hearts may be misguided

The passion for procedures to fix ailing arteries and hearts may be misguided | Heart and Vascular Health | Scoop.it
How gaps in medical knowledge affect matters of the heart
Seth Bilazarian, MD's insight:

David Jones, medical historian gives a review of the history of coronary bypass (CABG) and angioplasty (PCI). The essay does a good job putting into perspective the growth of these procedures. The medical approach has evolved from a belief that patients are "all fixed" when they receive a stent or have coronary bypass to our current understanding. We now recognize that these procedures need to be part of optimizing patients risk factors so the disease does not continue to worsen.
My concern about headlines like this is that patients will believe that stents are not appropriate under any circumstances and there is strong evidence that treatment for patients in the setting of a heart attack or threatened heart attack is valuable and often life saving.

Stents are not always valuable or appropriate, but a blanket impression that all stent procedures should be avoided puts patients at serious risk.

more...
No comment yet.