New DES More Effective To Reduce Restenosis Than First-Generation Stents: Dr Mitchell Krucoff

New DES More Effective To Reduce Restenosis Than First-Generation Stents: Dr Mitchell Krucoff
Monday, October 26, 2009 08:00 IST
Our Bureau, Bangalore

Newer drug eluting stents (DES) are proving to be significantly more effective and safer compared to the ‘first-generation’ drug eluting stents. DES is developed to reduce incidents of re-blockage or restenosis which occur with bare metal stents and almost all trials showed a marked reduction in restenosis rates. The ideal drug eluting stent is one which demonstrates high efficacy while maintaining excellent safety profile.

The latest stents made of polymer and steel are known for higher biocompatibility. These are thinner in appearance and more flexible. The lower doses of the drug are much preferred as a long treatment option for complex and difficult cases. Another big advantage is the negative side effects. The drug eluting stents reduced the need for a second intervention procedure by about 40 to 50 per cent compared to bare metal stents especially in complex cases where patients reported long blockages in diabetics and those having small blood vessels, according to Dr Mitchell Krucoff, interventional cardiology scientist and advisor to US FDA on medical devices.

Dr Krucoff who is in India to research on medicine, healing and spirituality at the Sathya Sai Institute of Higher Medical Sciences in Bangalore, said that over 75,000 patients are treated with drug eluting stents each year in India. The ideal drug eluting stent is one that has proven in large clinical trials to reduce the chances of reblockage, morbidity and mortality.

According to the recently concluded international congress of interventional cardiology, Transcatheter Cardiovascular Therapeutics (TCT), in San Francisco, three separate large randomized clinical studies showed that the new generation drug eluting stent Xience V was significantly more effective and safe than the first generation Taxus stent.

India will account for 60 per cent of the global heart disease burden in the next few years, reports a recent study by a team of Indian and Canadian researchers. Indians have a genetic disposition to heart disease and develop disease earlier in their life compared to western population. Already the country set to become the diabetes capital of the world and it is forecasted that it will also be known for the highest incidence of heart disease, said Dr Krucoff.

Due to the effectiveness of stents, angioplasty is becoming the preferred choice of treatment of patients with narrowing of the blood vessels in the heart. These devices have evolved over the last two decades beginning from specialized balloons mounted on catheters to treat the narrowing to bare metal stents to drug coated stents. In India, use of drug eluting stents have increased dramatically since their introduction in 2003.

Going by the economies of scale, DES is being preferred to by-pass surgery in terms of faster recovery and higher productivity for the patient to get back to work at quicker pace, he added.

Interventional cardiology is a super specialty and the need of the hour is adequate number of trained experts. If there are specialists who have ample experience, they are most-sought after experts to implant DES. The number of cath labs should also increase to help specialist carry out the procedure. India is far higher in terms of expertise and use of stents than China. The country has a growing patient population who need DES which are affordable, said Dr Krucoff.

Pharmabiz Reference

Also see:
- Official Sathya Sai Baba Website
- Sri Sathya Sai Medical Trust
- Sri Sathya Sai Institute Of Higher Medical Sciences Whitefield
- Sri Sathya Sai Institute Of Higher Medical Sciences Prasanthigram

Baby With Abnormal Heart Breathes Easy Thanks To Sri Sathya Sai Institute Of Higher Medical Sciences

Sri Sathya Sai Institute Of Higher Medical Sciences Bangalore

Baby With Abnormal Heart Breathes Easy Thanks To Sri Sathya Sai Institute Of Higher Medical Sciences
15 Aug 2008, 0742 hrs IST, B S MANU RAO,TNN

BANGALORE: Eight-month-old Sinan from Kerala was a bonny baby with a charming smile. But behind that brilliant smile was a baby with a serious problem. He was born with his aorta having an extra arch.

Sinan’s breathing was laborious with a choked wind pipe and could not eat solid food. It was a dangerous condition that required complicated and expensive surgery, beyond the means of his parents.

Surgeons at the Sri Sathya Sai Institute of Higher Medical Sciences came to the rescue and performed a complex operation on the baby to rectify the complicated congenital defect. Now, the charming smile on Sinan’s face comes easier . “This was a rare condition known as double aortic arch. It accounts for only around one percent of all congenital heart diseases”, said Dr Choudary Voleti , the cardiac surgeon who led the surgical team.

The aorta is the biggest artery in the body and supplies blood pumped by the heart to all the vital organs. When it forms a ring around the wind and food pipes, it turns into a vice-like grip due to pressure of the blood inside the large artery.

“This made the surgery complicated and difficult. We had to identify a section of the arch in front of the wind and food pipes that we could sever and seal off. At the same time, we had to ensure it would not result in loss of blood circulation to any part of the body”, explains Dr Voleti.

After an angiography by Dr P K Dash, chief cardiologist at the hospital, and CT scan, the surgeons reached the aorta from the left side of the chest. The smaller of the two aortic arches was severed to let the food and wind pipes breathe normally.

“This procedure involved a team of paediatric cardiac surgeons to work in conjunction. These are rare surgeries and many surgeons never come across such cases through their careers”, adds Dr Voleti.

The charitable super speciality hospital saved another life. Many such babies, however, lose their lives for want of expensive healthcare. “This surgery would have cost over a lakh, not counting the diagnostic procedures. How can people from the economically weaker sections afford it?” asks a concerned Dr Voleti.

Reference

Also see:

- Official Website For Sathya Sai Baba