Sunday, May 25, 2008


Drug Eluting Stents ( DES ) is a very effective way of treating clinically important coronary artery disease. I feel that clinically insignificant CAD should receive intensive medical therapy. This will include those well people, without a positive stress ECG, who had a 64-MSCT and end up with angioplasty. There is no clinical evidence of benefit in this disease subset. Anyway, back to clinically significant CAD., and cheaper DES. At the just concluded EuroPCR, the dutch presented their experience with the use of the X-stent. This is a 60mm long stent, mounted within a sheath so that they digits do not fall off. It has a mechanism to break off the 6mm digits once the lesions is cross. This means that in the same patient, we can use the same X-stent system, to treat multiple lesion, as long as the combine length of all the lesions are less than 60mm. The X-stent is coated with the drug, biolimusA9 and has a biodegradeable polymer, which has been proven to be better than the drug paclitaxel. The company marketing this new generation stent is Biosensor, a Singapore company, now sold to the Europeans. I am rather keen because, it will allow me to avoid using multiple DES at RM 8K per DES. I see major cost savings here. I have of course approach the company to bring in the stent for me to use. Perhaps the PCI treatment of CAD will get cheaper. We shall see.

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