Bio-Engineered vs Bare Metal vs Drug-Eluting Stents

What are the merits of bio-engineered stents (BES) vs bare metal (BMS) or drug-eluting (DES)?

Current Postings (4):

• Desmond -- we are covering this new field (for example, this Forum Topic and various references in recent articles, including our October 4 feature, "Conor CoStar: New Stents May Be Solution to New Stent Problems"). We also are in the process of creating an entirely new section on "Emerging Technologies" which will have much more in depth information on these new devices. Actually, the TCT conference had a number of meetings on the new technologies, and they were very well-attended, so the word is definitely out. Sign up for our newsletter to get announcements of new sections, articles, etc.
Angioplasty.Org Staff, Angioplasty.Org, November 14, 2006

• In addition to bio-engineered stents, there have been quite a number of clinical trials involving bio-degradable stents, which means that the stent will revert to bare metal stents. Examples are Conor Medsystem (CE mark approved), Biosensors Int, Biomatrix (awaiting ce mark), Xtent, Devax, Nobori (from Terumo). I wish that your website will highlight more info from these new technologies, instead of always highlighting Taxus, Cypher, Endeavor, etc. For example, in the recently concluded TCT conference, hardly any mention was made of these new technologies - are they that passive? Are they not involved in the conference?
Desmond C., Singapore, November 11, 2006

• Suneil, given the controversy of the past couple months, cardiologists and patients alike are looking to the next generation of stents to solve some of the problems. There are several out there in research phases, clinical trials and some, like the stent your doctor mentioned, have achieved some approvals. The Genous stent works on a very interesting concept -- using a bio-coating on the surface not to suppress the growth of "scar tissue", which is what drug-eluting stents do, but rather to attract endothelial progenitor cells (EPC) in the blood which will result in a natural and fast covering of the metallic stent. It's a new technology that received CE mark approval a little over a year ago, and is not yet available in the U.S. The positive side is that patients would not need to take long-term dual antiplatelet therapy and that hopefully the issue of late stent thrombosis, a very low-frequency but potentially catastrophic event, would not be an issue. Have any physicians or patients out there had experience with this or other new devices? Let us know.
Angioplasty.Org Staff, Angioplasty.Org, October 30, 2006

• 2 months back, my CT scan showed a 70% blockage in the LAD with a potential 50% (soft plaque) blockage in the Left Main and less than 50% in the right circumflex. We were against an angioplasty due to the Stent Controversy. With a significant change in lifestyle, my Cholesterol has recently been lowered to 98 mg with a HDL:LDL ratio of 1.08. My doctor advises an Angio is necessary for proper diagnosis - with the intent to do an Angioplasty if the blockage is more than 70%. However, if the major blockage involves the Left Main, a Bypass would be his recommendation. In case a stent is used, he suggests a bio engineered stent (BES???) called Genous. Marketing materials suggest this (BES) is a safer and more pragmatic option, but there is less than 12 months of data available. Is the data available adequate to form a reasonable opinion? What are their merits vs BMS vs DES. Are there any other factors we should be aware of with the use of Bio Engineered Stents? My procedure is being scheduled for next week.
Suneil, Singapore, October 30, 2006

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