Drug Eluting Stents



DRUG ELUTING STENTS

by Heidi Turner

Drug-eluting stents, also known as medicated or drug-coated stents, have recently been linked to cardiac events including blood clots and heart attacks.

Stents are small, metal tubes used to expand arteries that have narrowed because of plaque build-up. A narrowing of arterial walls can slow or even block blood flow, preventing the heart from receiving enough blood and resulting in a heart attack. Stents were added to angioplasty, in which doctors expand clogged arteries with tiny balloons, in order to keep open arteries that were clogged by plaque. Previously, doctors had used only balloons to keep arteries open, but in approximately half of all angioplasty patients with only a balloon, the arteries closed up again.

Doctors then began using the angioplasty balloon to expand a wire mesh sleeve (the stent) inside the artery in an attempt to keep the artery open. However, in 20-30% of cases the cells grew over the wire, re-closing the artery.

The next method to prevent arteries from re-closing was the drug-eluting stent. Drug-eluting stents are coated in drugs that prevent the growth of cells and lower the re-closing rate to around 5%. However, preventing cell growth can result in pieces of the stent protruding from the artery and leaving a place for the formation of a blood clot inside the stent. Blood clots can cause heart attacks.

One report puts the risk of blood clotting in patients with drug-coated stents as much as five times higher than in patients with the bare-metal stents. As many as 2,000 people die each year in the US from drug-eluting stents.

Drug-eluting stents are manufactured by Boston Scientific (makers of the Taxus stent), and Cordis (makers of the Cypher stent, and a subsidiary of Johnson & Johnson). They were approved for use by the FDA in 2003. A report at MSNBC.com estimates that doctors implant drug-eluting stents in a million Americans every year.

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