Medicated Stents Reduce Restenosis

Newer-generation stents that slowly release medication are far more effective than conventional stents in preventing the overgrowth of scar tissue, thereby reducing the incidence of restenosis, heart attack, and death.

A new study conducted at the cardiovascular intervention center of Cedars-Sinai Medical Center ( Los Angeles, CA, USA) is one of very few to focus on drug-eluting stents for use in vein grafts from the legs, which pose unique challenges for cardiologists. The medicated stents appear to provide localized benefits, preventing restenosis at the site of the stent but not in other parts of the bypass graft, which often occurs.

Michael S. Lee, M.D., the study's first author and an interventional cardiologist at Cedars-Sinai, said old vein grafts have a "mucky” appearance. "They are more likely to build up atherosclerotic plaque over long sections and to be filled with cholesterol debris and blood clots.”

Over time, half of all veins removed from the legs and attached to the heart to replace clogged coronary artery grafts become diseased to the point of requiring re-intervention, either repeat open-heart surgery or balloon angioplasty with the insertion of a stent.

The study, published in the November 2005 issue of the Journal of the Society for Cardiovascular Angiography and Interventions, found that there was a fourfold reduction in the incidence of restenosis with the medicated stents in comparison to conventional stents.