 | Joseph P. Galichia, MD is the founder and Medical Director of the Galichia Medical Group, PA. He is an internationally recognized pioneer in the field of interventional cardiology. In the 70's, Dr. Galichia studied in Zurich, Switzerland with the inventors of the balloon angioplasty technique for treating heart disease. As a result of his experience, he was able to bring this historic technique back to the United States where he was one of the first physicians to perform coronary angioplasty here. A noted medical spokesman, he appears on a weekly Newstalk segment on KWCH Channel 12 and has a weekly syndicated radio talk show on KNSS 1330 AM every Saturday live from 11:00 am to noon. Dr. Galichia may be contacted by sending an e-mail to service@galichia.com |
Health & Medicine
2007-10-01 11:09:00
Medicated stents vs. non-medicated
Answer: A study has been released just days ago showing that after a 3-4 year period, medicated stents show a superiority over bare metal stents in both the restenosis rates and are at least as good if not better in terms of overall survival.
Only approximately one year ago we had information indicating that medicated stents used in coronary arteries may be related to higher incidence of late clotting problems resulting in heart attacks and sudden death. Although this number was relatively low, ie; less than five per thousand, it was felt that medicated stents posed a specific hazard in this regard. Also it was noted that patients who continued to take Plavix, a blood thinner we always give patients with stents, had almost none of these late clotting problems.
The new information is impressive in that it indicates no real difference in clotting problems or heart attack incidents in patients with medicated stents. In fact, the data would tell us that the medicated stents are slightly better in this regard long term and that most importantly the incidence of patients having to come back for a second stent or another procedure such as a bypass operation is markedly less in the patients with medicated stents. Clearly medicated stents protect the artery from recurrences and have only about a five percent recurrence rate within the stented area. This compares to an approximate 25% restenosis rate in patients who have bare metal stents.
Our current thinking is that medicated stents are definitely worth the extra cost and that patients that have medicated stents probably should stay on Plavix and aspirin as long as possible. Previous guidelines recommended staying on these medications for three to six months but we are now telling our patients to stay on these drugs indefinitely. This has resulted in highly satisfactory short and long term outcomes when using medicated stents.
