Friday, March 13, 2009

THE BIOADSORBABLE STENTS

The March 14th issue of the Lancet carried an article by the prolific writer, Dr Patrick Serruys, on the ABSORB trial. The ABSORB study is a study on the new generation of DES ( Drug-Eluting Stents ). DES, as we all well know has this problem of stent thrombosis, which can occur at practically, anytime. From the early stages till the very late stages ( and I mean 2-3 years out ) after successful stent implantation. Some have reasoned that this could be due to the presence of metal and also the polymer. There was therefore alot of interest in the invention of a bioabsorbable stent, which hopefully will melt ( bioabsorbed ) away, months after implantation, thereby hopefully eliminating late stent thrombosis. Well, Dr Serruys and group, implanted this new generation everolimus bioabsorbable stent ( made by Abbott ) into 26 patients about 2plus years ago, and in the latest issue of Lancet, annouced their results. It showed basically that the concept was good and after two years, the stent was well absorbed by the vessel wall, leaving almost no stent material ( in one-third of patients ). The MACE rates were good.
I gather that this small study was basically a proof of concept and now we will see refinement of the stent, including new stent material and follwoing that larger clinical trials, with larger number of patients.
Well for a start, looks like the biuoabsorbable stent is on the way. We must be about 4-5 years from clinical usage.
Suffice to say that it is an improvement on the present generation DES ( the current second generation DES is very good ), but at what cost? I don't think that the bioabsorbable stent is going to be cheap or cheaper than the current second generation DES.
Well, we call this progress.

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