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March 15, 2020

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July 31, 2011

Small, thin, and Silver; it will save your life

For years, controversy has raged throughout Medical Journals that explore key pivotal issues in cardiology. Stents are a 4 billion dollar a year business, as it should be, considering that it has saved the lives of millions of people. This piece of meshed metal that props open arteries has prevented and provides a greater chance of recovery for heart related issue.

With a lot of money at stake, medical technology companies continually push hard to develop new products. So when criticism is brought against them, it is natural to have some resistance and push hard against research suggesting that products do not work correctly, are overused, or whether we generally need it in the first place.

It is continually necessary for industry research to develop technologies and implement them into practice. Whether it is met with controversy needs to be seen. I don't believe that omitting information showing older technology is worse than newer technology, is a good thing, however there always needs to be a continual strive to do better. With published series of articles that compare drug eluting stents, such as those by Abbott and their Xience product, it has put them on the map and a current market leader.

However, despite major improvements in antiplatelet therapy, thrombotic events remain the primary cause of death after percutaneous coronary interventions. Sirolimus-eluting stents and polymer-based paclitaxel-eluting stents have been shown to reduce neointimal hyperplasia and risk of restenosis without increasing the risk of stent thrombosis. Operators are now using drug-eluting stents for a wide variety of clinical and anatomic situations, many of which have not been evaluated in randomized studies. With this increase use of Drug eluting stents (DES), it was initially praised as a great step forward and advancement. However, with a high number of stents being put in, benefits and disadvantages have been able to become clearer. These stents, as opposed to bare metal stents are able to deliver drugs when implanted into the arteries, hopefully reducing inflammatory responses.

However, many times, only negatives are brought forward and challenges are brought against the industry leaders. Doctors are always "practicing" medicine, so it takes time to determine whether a product works or not. There are always questions of whether some stent implantations are necessary, however there has to be a usage to determine whether the stents work or not.

Each year there are about 700,000 people in the United States will have a stent implanted either after they have a stroke or a heart attack. This will help one from happening again or relieve chest pain. These devices are medical breakthroughs, and whether doctors are implementing too many, is to be seen. I would never want something happening to someone when it could be avoided easily with this procedure. I don't think that we are paying too much as a society, but we will have to see what future experts have to say.


Incidence, Predictors, and Outcome of Thrombosis after Successful Implantation of Drug-Eluting Stent - American Medical Association
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