Drug-coated stents less risky for heart bypass patients

January 22, 2009

Coronary bypass surgery may carry less risk of serious complications if stents coated with a drug that suppresses cell growth are used in the procedure rather than bare-metal stents, UT Southwestern Medical Center researchers and colleagues have found.

The study, appearing online and in an upcoming issue of The Journal of the American College of Cardiology, is the first large, multicenter trial comparing two types of commonly used stents. Stents are small mesh tubes that reinforce the walls of blocked blood vessels. In this study, stents were used to treat blockages in diseased coronary arteries.

In bypass surgery, grafts are taken from the saphenous vein in the patient's thigh and sewn to the coronary arteries to help improve blood flow to the heart, relieve severe chest pain and reduce the risk of heart attacks from blocked arteries. Years after surgery, those grafts may develop blockages inside the graft that are challenging to treat because of high rates of recurrence.

"We wanted to see if one type of stent was superior in reducing the incidence of re-narrowing of the vein graft," said Dr. Emmanouil Brilakis, assistant professor of internal medicine at UT Southwestern and lead author of the study. "Stented vein grafts have a very high risk of re-narrowing - sometimes up to 50 percent when bare metal stents are used.

"Drug-eluting stents could provide a solution to this problem, but limited clinical results have been reported to date. The drug-eluting stents examined in our study are coated with a medication called paclitaxel, which inhibits cell growth."

The drug coating is contained on a polymer that covers the surface of the stents and eventually elutes, or washes out of the stent, over a period of several months or years.

In the study, researchers examined 80 patients, roughly half of whom had vein grafts with drug-eluting stents and the other half who had the same procedure with bare-metal stents.

Researchers found that 51 percent of patients with the bare-metal stent had re-narrowing of the vein graft over several months compared with 9 percent of the drug-eluting stent group. In addition, 28 percent of patients who had a bare-metal stent required another procedure to treat the same blockage, while only 5 percent of patients who had the drug-eluting stent did.

Some previous studies have indicated that patients receiving drug-eluting stents in saphenous vein grafts may not reduce the risk of re-narrowing and may be associated with increased risk of death, Dr. Brilakis said.

"Our findings suggest that drug-eluting stents are a better choice than bare-metal stents for this type of procedure," he said. "Patients receiving paclitaxel-eluting stents in our study were significantly less likely to have recurrence of their graft blockage and to require repeat procedures. The rates of death were similar in both study groups, although our study was not designed to detect differences in mortality."

The researchers now hope to repeat the study in an expanded group of patients, which would provide important data to determine definitively the efficacy and safety of each kind of stent.

Source: UT Southwestern Medical Center

Explore further: New tissue-engineered blood vessel replacements one step closer to human trials

Related Stories

New tissue-engineered blood vessel replacements one step closer to human trials

November 1, 2017
Researchers at the University of Minnesota have created a new lab-grown blood vessel replacement that is composed completely of biological materials, but surprisingly doesn't contain any living cells at implantation. The ...

Team creates functional, stem-cell-derived small bowel segments

October 10, 2017
Using human induced pluripotent stem cells (iPSCs), a Massachusetts General Hospital research team has bioengineered functional small intestine segments that, when implanted into rats, were capable of deliver nutrients into ...

In utero stem cell transplants may replace riskier childhood transplants for multiple conditions

August 31, 2017
UCSF Benioff Children's Hospitals in San Francisco and Oakland will pioneer stem cell transplants for a uniquely challenging patient population: second-trimester fetuses stricken with a potentially fatal disease.

New treatment on the horizon for type 1 diabetes sufferers

September 8, 2017
Patients suffering from type 1 diabetes may soon have access to improved approaches to treat the disease, courtesy of new research out of Sydney's Westmead Institute for Medical Research.

Researchers develop treatment to reduce rate of cleft palate relapse complication

September 22, 2017
Young people with cleft palate may one day face fewer painful surgeries and spend less time undergoing uncomfortable orthodontic treatments thanks to a new therapy developed by researchers from the UCLA School of Dentistry. ...

Drug-eluting stents more benefit in saphenous vein graft

August 30, 2016
Drug-eluting stents had a clear advantage over bare metal stents in patients undergoing revascularisation of saphenous (leg) vein grafts, results of the BASKET-SAVAGE trial show.

Recommended for you

Hibernating ground squirrels provide clues to new stroke treatments

November 17, 2017
In the fight against brain damage caused by stroke, researchers have turned to an unlikely source of inspiration: hibernating ground squirrels.

Age and gut bacteria contribute to multiple sclerosis disease progression

November 17, 2017
Researchers at Rutgers Robert Wood Johnson Medical School published a study suggesting that gut bacteria at young age can contribute to multiple sclerosis (MS) disease onset and progression.

Molecular guardian defends cells, organs against excess cholesterol

November 16, 2017
A team of researchers at the Harvard T. H. Chan School of Public Health has illuminated a critical player in cholesterol metabolism that acts as a molecular guardian in cells to help maintain cholesterol levels within a safe, ...

Prototype ear plug sensor could improve monitoring of vital signs

November 16, 2017
Scientists have developed a sensor that fits in the ear, with the aim of monitoring the heart, brain and lungs functions for health and fitness.

Ancient enzyme could boost power of liquid biopsies to detect and profile cancers

November 16, 2017
Scientists are developing a set of medical tests called liquid biopsies that can rapidly detect the presence of cancers, infectious diseases and other conditions from only a small blood sample. Researchers at The University ...

FDA to crack down on risky stem cell offerings

November 16, 2017
U.S. health authorities announced plans Thursday to crack down on doctors pushing stem cell procedures that pose the gravest risks to patients amid an effort to police a burgeoning medical field that previously has received ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.