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Angioplasty breakthrough.

In October 2001, Medical Update spoke with the brilliant cardiologist and coronary gene therapy pioneer Dr. Jeffrey Isner, whose legacy lives on at St. Elizabeth's Medical Center in Boston. We asked Dr. Isner whether coronary gene therapy might soon replace angioplasty and invasive bypass surgery. Always on the forefront of medical breakthroughs, Dr. Isner told us that a solution to a decades-old problem with restenosis (renarrowing of the arteries) after balloon angioplasty and stent placement to keep the arteries open would first bring sweeping changes in the field.

"Early trials of coated stents show very little rate of restenosis," Dr. Isner told us. "If the stents continue to hold up in studies, it will mean that angioplasty operators will start tackling all kinds of cases that are now using bypass surgery, because the risk of restenosis will be so low."

Dr. Isner's prediction is fast becoming a reality, as results from clinical trials in Europe, Brazil, and the United States of a new sirolimus-eluting stent demonstrate impressive results. According to researchers and experts in the field, the new stents that are coated with, and slowly release, certain drugs are poised to "revolutionize" the treatment of coronary artery disease.

At the American College of Cardiology's annual scientific conference, researchers from Brazil presented dramatic results in patients who received the sirolimus-coated stent. Two years after undergoing balloon angioplasty and receiving a sirolimus-coated stent, not one of the patients who received the sirolimus-coated stent suffered restenosis.

"The long-term clinical results showed zero percent mortality and zero percent restenosis," Dr. J. Eduardo Sousa, lead researcher in the Brazil trial, told fellow researchers.

"The initial data are just amazing," says Dr. Michael Cleman, professor of medicine at Yale University School of Medicine and director of the cardiac catheterization and interventional lab at Yale-New Haven Hospital--one of the 50-plus centers across the United States now testing a sirolimus-coated stent. "If this tends to work out, I would anticipate that we'd be looking at a whole new era of stenting."

If results continue to demonstrate positive results, the sirolimus-coated stents could receive government approval as early as next year.
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Title Annotation:Neighborhood Heart Watch
Publication:Medical Update
Geographic Code:1USA
Date:Jun 1, 2002
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