Coated stents may not be the best treatment

November 24, 2006|By Los Angeles Times

Wire mesh tubes called stents are widely used to prop open previously blocked coronary arteries - and they're often coated with drugs, which are thought to help keep the arteries open even more effectively.

Recent studies, however, have shown that, in many cases, the arteries narrow again despite the drugs.

Some physicians also suspect that drug-eluting stents are more dangerous than uncoated stents and that stents in general may irritate vessel walls.

A small study presented at a national cardiologists' meeting and reported online on the New England Journal of Medicine Web site suggests an alternative for keeping the vessels from closing - coating the balloon used for angiography with a drug that inhibits plaque formation.

Dr. Bruno Schellar and his colleagues at Saarlandes University in Homburg/Saar, Germany, studied 52 patients who received a stent only to have the artery close again.

Half the patients had the artery reopened with an uncoated balloon and half with a balloon coated with the drug paclitaxel. Six months after the treatment, 43 percent of those treated with the uncoated balloon had a renarrowing of the artery, compared with 5 percent of those treated with the paclitaxel-coated balloon, Schellar said.

He speculated that the coated balloon may be more effective than a stent because it distributes the drug more widely and is less irritating to vessel walls.

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