As safety concerns surround the use of stents to keep clogged heart arteries open, a team of German doctors is recommending a new technique.
In a study to be published in this week’s New England Journal of Medicine, the German doctors said stents — tiny mesh tubes used to prop open heart arteries after blockages have been cleared — should be scrapped.
Instead, they recommend directly painting the inner wall of the affected artery with the drug paclitaxel using the same type of balloon used to reopen the artery in the first place.
It’s a “potentially promising approach” said Edoardo Camenzind of University Hospital in Geneva in an editorial in the journal.
Such a technique was tried and abandoned in the 1990s. But with a better way to apply the drug to the artery wall, “it may be that we can make progress in this field by going ’back to the future’,” Camenzind said.
The study, presented at an American Heart Association meeting in Chicago, was small, involving only 52 patients whose stents had become clogged.
Yet six months after treatment, the arteries had re-narrowed in only 5 percent of the volunteers whose arteries had been dabbed with paclitaxel, compared with 43 percent of the people whose arteries had 60 seconds of contact with an uncoated balloon.
The team, led by Bruno Scheller of Saarlandes University in Homburg/Saar said dabbing on a coating of paclitaxel may be better than a drug-releasing stent because the drug is distributed more evenly along the artery wall when the balloon is used.
In addition, the balloon technique avoids the irritation that might be caused by the stent struts themselves as they constantly press against the artery wall.
Keeping an artery open using drugs “may not require the implantation of stents and a prolonged release of a drug,” they said.
The study coincides with troubling times for the $6 billion global market for stents, which once implanted stay in the artery permanently to improve the flow of blood to the heart muscle and relieve symptoms such as chest pain.
The devices have come under scrutiny amid studies suggesting drug-eluting stents may raise the risk of blood clots months after they are implanted.