Will a dissolving stent solve the problem of restenosis?
Ethan C. Korngold, M.D.
Cardiologist, medical director for cardiovascular research, Providence Heart and Vascular Institute
Published Jan. 27, 2014
Providence St. Vincent Medical Center is pleased to participate in the ABSORB III clinical trial of the Absorb bioresorbable vascular scaffold. Ours is the only site in the Portland area, and among just a few sites in the Pacific Northwest, to offer this groundbreaking technology.
Currently, coronary artery disease severe enough to cause chest pain or a heart attack often is treated with coronary artery stents to restore blood flow. Modern stents are made of thin metallic struts coated with an antiproliferative drug to prevent restenosis – a renarrowing of the vessel that can occur during the healing process.
Modern stents have been hugely successful in reducing rates of restenosis, which used to occur in up to half of balloon angioplasties and 30 percent of cases in which bare metal stents were used. With modern drug-coated stents, the incidence of restenosis is about 5 to10 percent.
The Abbott Absorb bioresorbable vascular scaffold represents the next step in the evolution of coronary artery interventional technology. The biodegradable stent-like device is completely absorbed by the body within about 18 months.
Like metallic stents, Absorb is delivered into a coronary artery via a balloon catheter. In the short term, this stent has similar physical properties to a metallic stent, with similar radial force to keep the vessel propped open.
The Absorb scaffold is coated with a drug-eluting polymer to prevent restenosis, just like a metallic drug-eluting stent. As the scaffold dissolves, the healing coronary artery is able to dilate and constrict to accommodate the natural variations in blood flow, allowing the artery to become flexible again.
By receiving more natural blood vessel function, patients may experience fewer chest pain symptoms than with existing technologies.
Despite preventive strategies and medical therapy, patients with coronary artery disease frequently develop new areas of disease that require future intervention. One important goal for bioresorbable scaffolds is they will improve future coronary artery interventions by avoiding so-called "full metal jacket" stent revascularization and also by preserving potential targets for coronary artery bypass grafting.
Patients with stable or unstable angina, with no evidence of myocardial infarction and who have coronary artery anatomy suitable for device implantation, may be eligible to participate in the ABSORB III trial.To learn more contact Trent Foxley, clinical research coordinator, at 503-216-7195.