Drug-eluting stents outperform radiation treatment for coronary restenosis in bare me...( (2.6 percent for brachytherapy and 1.6...),Health

"The results are what everyone was hoping for. Drug-eluting stents should now be considered the standard of care for most patients with restenosis of previously implanted bare metal stents, and radiation treatment should be abandoned," said Gregg Stone, M.D., professor of medicine at Columbia University College of Physicians and Surgeons, director of cardiovascular research and education at the Center for Interventional Vascular Therapy at NewYork-Presbyterian Hospital/Columbia, and vice chairman of the Cardiovascular Research Foundation.

Other trials in the past few years have shown drug-eluting stents to be superior to bare metal stents in preventing restenosis, when used for initial stent placement inside a coronary artery. The TAXUS-V ISR trial was designed to determine the safety and efficacy of drug-eluting stents as an alternative to vascular brachytherapy in treating restenosis resulting from previously implanted bare metal stents. Vascular brachytherapy is effective in some patients, but the procedure is costly and complex, and years later, can cause complications, such as thrombosis and more restenosis.

Although the majority of first-time stents used in coronary arteries are now drug-eluting, bare metal stents continue to be used for conditions where studies on drug-eluting stents are still incomplete (e.g. acute myocardial infarction). Bare metal stents are also used in countries where the cost of drug-eluting stents is not covered and in select patients who can't tolerate an extended course of dual anti-platelet therapy.

"The single most common reason for referral to bypass surgery after bare metal stent implantation is still recurrent restenosis," said Dr. Stone. "Identification of drug-eluting stents as the optimal therapy for bare metal restenosis should significantly reduce the need for surgery in many thousands of patients."

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Contact: Craig LeMoult
cel2113@columbia.edu
212-305-0820
Columbia University Medical Center
12-Mar-2006