The latest developments in stent technology for treating coronary heart disease.
BASED on the latest WHO data published in April 2011, the number of deaths from coronary heart disease (CHD) in Malaysia accounts for 22.18% of total deaths.
In this modern day and age, however, there are various treatments for CHD, which include medication, coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI).
PCI is also called balloon angioplasty, in which a doctor threads a catheter into the coronary artery and inflates a balloon at the tip. Then, a wire-mesh structure called a stent is left behind to keep the artery open and prevent it from narrowing again.
Between the two methods of revascularisation in treating CHD, PCI is much less invasive, has a lower risk of procedural stroke, shorter hospital stay and recovery period, and is done through a pin-hole compared to bypass surgery.
The survival to 10 years is similar for both procedures. As a result, PCI is performed more commonly than CABG in the treatment of patients with CHD.
In Washington state in the US, the prevalence of PCI is almost five times more than CABG.
The latest developments in PCI procedures were recently highlighted by consultant interventional cardiologist Dr Yap Yee Guan. According to Dr Yap, Malaysians are still not fully aware of the existence of various stents in the country. He also explained that many Malaysians are unaware of PCI as a treatment for heart attacks.
Describing the procedure used in PCI, where stents are inserted to keep the artery open, Dr Yap said, “There are various types of stents, which have distinctive properties, as well as advantages and disadvantages. Patients should seek proper consultation from their respective cardiologist on the suitable type of stent to be used, as the indication for each patient may be different.”
Dr Yap explained about the three types of coronary stents available, namely, bare metal stents (BMS), drug eluting stents (DES), and bio-engineered stents (BES). Clinically, DES and BES are more efficacious and have better long-term outcomes, though at a higher cost than BMS.
Dr Yap highlighted that there will be a new innovative stent that has a drug as well as a bioengineered surface, known as dual therapy stent (DTS), which will be available in Malaysia by mid-2012. DTS combines properties of a drug-eluting stent (DES) and bio-engineered stent (BES) to address the issue of restenosis (renarrowing of the artery) and to improve healing and safety.
According to Dr Yap, post-surgery medication treatment such as dual-antiplatelet therapy (DAPT) is vital as it reduces the chances of blood clot after stenting.
REMEDEE, the trial of the new DTS stent, was presented last year at a major conference in San Francisco. This is a multinational trial with participation from 17 sites and eight countries. Two sites from Malaysia that participated in this trial were Institut Jantung Negara, Kuala Lumpur, and Pusat Jantung Hospital Umum, Sarawak.
http://thestar.com.my/news/story.asp?sec=health&file=/2012/3/4/health/10830306
0 comments:
Post a Comment