Opening Things Up:
Medicated Stents Prevent Re-narrowing
Arteries are the body’s version of interstate highways. Blood flows through them as it circulates from the heart throughout the body. When an artery becomes clogged or blocked, it’s a traffic jam with serious consequences.
Interventional cardiologists help repair blocked arteries. When a blockage occurs, cardiologists often use balloon angioplasty to re-open the clogged arteries. To keep them open, cardiologists insert stents (small, porous metal tubes), which act as scaffolding to prop open the blood vessel.
In most instances, stents work well. However, as the body heals, excessive scar tissue can grow in the artery and cause re-narrowing at the site of the intervention (restenosis).
Restenosis happens to about one in every five patients within six months of an angioplasty. Because restenosis causes a re-narrowing of the arteries, it can lead to serious consequences, such as a heart attack.
Earlier this year, a new tool to prevent restenosis became available. Drug-coated stents were approved by the U.S. Food & Drug Administration. Cardiologists in the Lancaster General Heart Center have been using the stents since spring and were among the first in the nation to do so.
To the naked eye, drug-coated stents (also called medicated or drug-eluting stents) look the same as traditional stents. The primary difference is the drug bonded to the metal of the drug-coated stents.
When a cardiologist inserts the drug-coated stent into the artery, it props open the artery and gradually releases medication. Lancaster General Heart Center cardiologists use stents coated with sirolimus.
“The medication (sirolimus) stops cells from dividing in the stented area,” says Michael Lesko, DO, Cardiac Consultants. “Healing still occurs, but without the same level of scar tissue.”
Because drug-coated stents are a newer technology, they are not available in the same variety of sizes and materials as regular stents. However, Richard Gentzler, MD, The Heart Group, sees change on the horizon.
“Researchers are improving the stents by using different substances and medications and adding more sizes,” says Dr. Gentzler. “Initial studies indicate that, in many cases, drug-coated stents can save a patient a return trip to the hospital for further coronary interventions.”
While drug-coated stents offer benefits, Scott Riebel, MD, Heart Specialists of Lancaster, notes they may not be appropriate for use in all situations requiring stent implantation. However, like Drs. Gentzler and Lesko, he’s encouraged by the tremendous strides being made in cardiac research.
“I see this as being an exciting time in interventional cardiology. We are able to provide patients with a level of care that has never been available before,” Dr. Riebel explains.
Even with the great advances, all three cardiologists say heart health begins with the individual. When patients leave the hospital, they should understand the consequences of heart disease and be encouraged to make lifestyle changes to prevent additional health problems.
Education is a powerful tool in preventing heart disease. Lancaster General Hospital offers several programs to help people make lifestyle changes. These informative programs include cardiac rehabilitation, stress reduction, smoking cessation and weight management. For information on these programs and the Lancaster General Heart Center, click here.
Risks for developing heart disease include:
- Excessive body weight
- High blood pressure
- High cholesterol
To reduce your risk and improve your heart health, you should:
- Maintain a healthy diet (low in saturated fats and cholesterol)
- Get regular cardiovascular exercise (keep your heart and body in good shape)
- Do not smoke
- Reduce stress