Transcript Dissolvable Heart Stents

Dissolvable Heart
Stents
Richard Melpignano
Coronary Heart Disease
 Coronary Heart Disease (CHD) is, as of 2012, the
leading cause of death worldwide.
 Plaque in blood accumulates against the walls of the
Coronary Artery, which returns oxygen rich blood from
lungs to heart
 If left untreated, will lead to blood clots/heart attacks
Traditional Treatments
 Coronary Artery Bypass Surgery (High Risk)
 Cholesterol Lowering Medication, Nitroglycerin, BetaBlockers etc. (Less Effective)
 Angioplasty
Angioplasty
 Minimally invasive
 Involves the insertion of a mesh stent which expands to
fit the coronary artery, forcing plaque against the artery
wall, allowing significantly increased blow flow to the
heart
 Stents have traditionally been made of various metals,
and may or may not be drug eluting
Problems
 Effective, but often delay natural healing process of the
arteries
 If metal mesh is not inserted properly, plaque may
actually build up on the stent, called stent thrombosis
(kills 1 in 200 patients in procedure)
 To improve upon these conditions, Abbott Laboratories
in IL have been working on a biodegradable polymer
drug eluding stent
Polymer (DES) Stent
 Made of biodegradable material called polylactide
 Inserted into Coronary Artery through similar method as
metal stents
 Designed to completely dissolve into the bloodstream
within 2-3 years after procedure
Procedure
 A dye that can be seen on X-rays is released into the blood
in order to pinpoint the location and severity of the blockage
 Catheter is inserted into the patients body, usually into the
groin, but may be inserted into the arm or thigh as well
 Catheter is lead along the artery until it reaches the
blockage, where the mesh is forced against the artery wall
through the inflation of a balloon, compressing the plaque
blockage
 The balloon is deflated and the catheter is removed from the
body
Results
 In comparing metal stents with metal DES stents, the
DES stents have shown more instances of heart
complications than ones without supporting drugs
 But, biodegradable DES stents were found to be safer
than both of the metal stents
 The risk of stent thrombosis, lesion revascularization,
and myocardial infarction were significantly reduced
ABSORB III Clinical Trials
 Early in September, these trials enrolled 2,250 patients
across the country to test the effectiveness of
dissolvable heart stents
 Some facilities participating include Mount Sinai
Medical Center and the Stony Brook University Heart
Institute
Future
 Many physicians believe that these dissolvable heart
stents will someday replace metal stents (which have
been used in over 6 million procedures)
 It was approved for testing in Europe in 2011 and has
been successful in trials
 If trials are successful, it is expected to be available in
the United States by 2015
 The cost is estimated to be between $1500-$2000
Work Cited

[1] Cutlip, Donald, MD, and J. Dawn Abbott, FACC. "Coronary Artery Stent Thrombosis: Incidence and Risk Factors." Coronary Artery
Stent Thrombosis: Incidence and Risk Factors. Up To Date, 13 May 2013. Web. 26 Sept. 2013.
<http://www.uptodate.com/contents/coronary-artery-stent-thrombosis- incidence-and-risk-factors>.

[2] "European Heart Journal." Biodegradable Polymer Drug-eluting Stents Reduce the Risk of Stent Thrombosis at 4 Years in Patients
Undergoing Percutaneous Coronary Intervention: A Pooled Analysis of Individual Patient Data from the ISAR-TEST 3, ISAR-TEST 4,
and LEADERS Randomized Trials. N.p., 21 Jan. 2012. Web. 26 Sept. 2013.
<http://eurheartj.oxfordjournals.org/content/early/2012/03/22/eurheartj.ehs086.abstract>.

[3] "How Are Stents Used?" - NHLBI, NIH. National Heart, Lung, and Blood Institute, n.d. Web. 26 Sept. 2013.
<http://www.nhlbi.nih.gov/health/health-topics/topics/stents/used.html>.

[4] Jaspen, Bruce. "Abbott's Dissolvable Heart Stent Gets OK for Use in Europe." Chicago Tribune. N.p., 10 Jan. 2011. Web. 26 Sept.
2013. <http://articles.chicagotribune.com/2011-01-10/health/ct-biz-0111- abbott-stent-20110110_1_drug-coated-metal-dissolvableheart-stent-absorbable-stent>.

[5] Lüscher, Thomas, MD, Jan Steffel, MD, Franz R. Eberli, MD, Michael Joner, MD, Gaku Nakazawa, MD, Felix C. Tanner, MD, and
Renu Virmani, MD. "Drug-Eluting Stent and Coronary Thrombosis." Biological Mechanisms and Clinical Implications (2007): n. pag.
American Heart Association- Circulation. Web. 26 Sept. 2013. <http://circ.ahajournals.org/content/115/8/1051.full>.

[6] "Stony Brook Heart Institute Evaluates First Dissolvable Stent." Stony Brook Heart Institute Evaluates First Dissolvable Stent. Stony
Brook University, 20 Sept. 2013. Web. 26 Sept. 2013.
<http://commcgi.cc.stonybrook.edu/am2/publish/Medical_Center_Health_Care_4/Stony_Brook_Heart_I
nstitute_Evaluates_First_Dissolvable_Stent.shtml>.

[7] Woods, Lauren. "Fully Dissolvable, Temporary Stent for Opening Heart Artery Blockages." Fully Dissolvable, Temporary Stent for
Opening Heart Artery Blockages. The Mount Sinai Hospital, 17 Sept. 2013. Web. 26 Sept. 2013.
<http://www.eurekalert.org/pub_releases/2013-09/tmsh-fdt091713.php>.