- The Washington Times - Sunday, March 6, 2005

ORLANDO, Fla. (AP) — A new generation of tiny, drug-coated metal scaffolds that prop open arteries has transformed heart care in just a few years and is allowing a growing number of people to avoid having bypass surgery.

The devices, called drug-coated stents, slowly release medication that prevents vessels from reclogging after procedures to open them.

At an American College of Cardiology conference yesterday, doctors reported that both brands sold today are equally effective at keeping blood flowing smoothly, although one might be better for diabetics. Both were vastly better than the metal stents that were standard just a few years ago.

Benefits of the drug-coated stents apparently last for years, and even large blockages in small vessels can be fixed. The devices work so well that when an older stent clogs, it is better to put a new drug-coated one inside it than to treat the problem with radiation as has been done in the past, one study found.

Competitors being developed could help cut the price of the devices. One type of stent even dissolves in the body once its job is finished.

“It’s looking very good,” Dr. Gerald Fletcher, a Mayo Clinic cardiologist, said of the evidence for drug-coated stents. “The benefit is going to be substantial in the long term.”

Clogged arteries can cause a heart attack. One solution is open-heart bypass surgery, in which blood vessels from elsewhere in the body are used to create detours around blockages.

A less drastic treatment is angioplasty, in which a tiny balloon is snaked through blood vessels to blockages and inflated to flatten them. Nearly 1 million of these procedures are performed each year in the United States, and in most cases, a stent is placed to keep the artery from squeezing shut again.

But even these reclogged about one-fourth of the time until drug-coated stents came along and cut the rate to about 5 percent. The first, Cypher, made by Cordis Corp., a Johnson & Johnson company, went on sale in Europe in 2002 and in the United States a year later. Boston Scientific Corp.’s Taxus stent was approved last year.

They use radically different drugs, and it hasn’t been known which is better. Yesterday, results of the first large comparison study showed them to be comparable.

It involved 1,353 patients in Europe, Latin America and Asia. Rates of heart attacks, strokes and repeat procedures were similar with both stents, reported Dr. Marie-Claude Morice of the Cardiovascular Institute of South Paris.

Cordis, which sponsored the study, claimed Cypher was safer because more blood clots occurred with Taxus, but Dr. Morice said the study wasn’t big enough or designed to answer that question.

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