Wednesday, May 18, 2011


The EuroPCR is currently on at Paris. One of the first papers presented was from Finland. The study is called BASE - ACS, basically, the use of this new generation bare metal stents in patients with the acute coronary syndrome. Dr Pasi Karjalainen and coleagues from the Satakunta Hospital Heart Center, Pori, Finland, studied 827 patients with ACS. To half they inplanted the new Titan 2 stent, and the other half received the Xience V ( DES ). At the end of 12 months, they found that the Titan 2 stent was non-inferior to the Xience V stent. The MACE rates were the same. I think they were attempting to say that the Titan 2 stent is as good as the Xience V.
The Titan 2 stent is basically a stainless steel stent, like the BX velocity, coated with Titanium Nitric Oxide. There is no polymer and no drug. Nitric Oxide, in animal experiments, has been shown to inhibit platelet aggregation, and also promotes healing.
I think that this new Titan 2 stent looks better then even the best cobalt chromium bare metal stent like the latest Medtronic integrity stent. I believe that the nitric oxide coating does confer some advantages. But, I must say that it is premature to say that Titan 2 is non-inferior to Xience V. maybe at 12 months in ACS patient that may be true. But we all know that DES are advantages because it lessens repeat target lesion revascularisation ( basically re-stenosis ) in the long term, like 3-5 years, and Titan 2 has not reach that place yet.
As the commentators discuss at the meeting, we are certainly pleased with the initial results of Titan 2, but certainly more work needs to be done. I do not think that this will spell the end of DES.
Of course, we are also keen to know the cost of this Titanium Nitric Oxide coated stent.
I am sure that we will hear more of Titan 2, in the future, be it good news or not so good news.

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