Stent Today, Gone Tomorrow

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Science Translational Medicine  07 Mar 2012:
Vol. 4, Issue 124, pp. 124ec39
DOI: 10.1126/scitranslmed.3003950

Clogged arteries can be opened by inserting and expanding a balloon in a procedure known as balloon angioplasty. For a more permanent fix, tiny wire mesh tubes called stents can be inserted inside the artery to keep the blood flowing. More than 1 million stents are implanted each year, yet artery reclogging (restenosis) is a major problem. To combat restenosis, Meredith et al. developed a new stent that is bioabsorbable and also able to deliver drugs that inhibit tissue growth after the procedure.

Meredith and colleagues recruited 291 patients with heart disease. The study evaluated the SYNERGY stent, a platinum-chromium drug-eluting stent (DES) coated with a bio-friendly poly(lactic-co-glycolic acid) polymer. Unlike conventional stent coatings, this polymer completely resorbs into the body in less than 4 months. This disappearing act may be beneficial in allowing the normal healing of the artery to take place and in reducing the long-term risk of stent thrombosis. The SYNERGY stent, delivering either full or half doses of the antiproliferative drug everolimus, was found to be comparable with a conventional DES by maintaining the arterial lumen size at 30 days and 6 months after stent implantation. This study is the first evidence that bioabsorbable stents have safety and efficacy similar to nonbioabsorbable DESs in humans.

A hybrid stent with both resorbable and permanent components could potentially provide both the long-term benefits of a permanent stent (keeping arteries open), while reducing deleterious effects on arterial healing (excessive tissue growth). This would benefit patients by reducing the need for anticoagulant therapies for years after stenting. Although an important first demonstration in people, further studies are needed to evaluate whether these stents have long-term benefits for patients with coronary disease.

I. T. Meredith et al., Primary endpoint results of the EVOLVE trial: A randomized evaluation of a novel bioabsorbably polymer-coated, everolimus-eluting coronary stent. J. Am. Coll. Cardiol. 15 February 2012 (10.1016/j.jacc.2011.12.016). [Abstract]

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