Category Archives: Stent

June 20, 2013 · 4:50 pm

USA Today Claims Stents and Angioplasty “Often Unnecessary”

Coronary StentYesterday’s edition of USA Today carried an article by Peter Eisler titled, “Six common surgeries often done unnecessarily” — and, you guessed it, angioplasty and stents were at the top of the list of “six common surgeries that carry significant risks of being done without medical necessity, according to federal data and independent studies.”

I was a bit taken aback because I was not aware of any new study, federal or independent, that concluded stents were being vastly over-used. And it turns out that there wasn’t one. Continue reading →

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Filed under Appropriate Use Criteria (AUC), Clinical Trials / Studies, COURAGE, FAME I / FAME II, Heart Attack, Media Coverage, Shared Decision-Making, Stent

May 25, 2013 · 6:53 pm

Oldest Stent Patient is Also Oldest Transradial Patient

Dr. Purshotam Lal and his 104-yr-old patient, Hari Singh

Dr. Purshotam Lal and his 104-yr-old patient, Hari Singh

Pretty amazing! Last week a 104-year-old man from Noida, India became reportedly the oldest patient ever to receive an angioplasty and stent. As reported in the Hindustan Times, Hari Singh was admitted to Metro Hospital and Heart Institute on May 16 with chest pain. Angiography showed two 100% totally occluded arteries and a 90% blockage near the origin of his Left Anterior Descending (LAD) artery.

Dr. Purshotam Lal, MD, FACC, FSCAI, who is the Director of Interventional Cardiology and Chairman, Metro Group of Hospitals, knew that his patient would probably only survive for a very short time if he did nothing. So he performed an angioplasty and stent implantation on Mr. Singh…and he went in through the left wrist, the transradial approach, to reduce discomfort to his patient and minimize the possibility of bleeding and vascular complications. Continue reading →

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Filed under Global Trends, Patient Experience, Patients, Stent, Transradial Approach, Video

February 18, 2013 · 4:44 pm

No More Financial Assistance for Plavix from Bristol-Myers But Are Generics Really the Same?

plavix_and_stentBristol-Myers Squibb (NYSE: BMY) is no longer offering its $37-a-month Plavix® Co-Pay Discount Card. And some patients are not happy about this. Additionally, according to the company’s web site for “Patient Assistance Programs,” the company is no longer making this life-saving drug available to patients who cannot afford it. This, of course, has something to do with the fact that brand-name Plavix has gone off patent and generic versions have been available since May 2012. (See our Patient Alert: How to Get the Best Price on New Generic Plavix.) But are the generic versions of clopidogrel really the same? Continue reading →

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Filed under Antiplatelet Medications, Drug-Eluting Stents, FDA, Patient Alert, Patients

January 23, 2013 · 7:15 pm

Back to the Future: Drug-Eluting Angioplasty Balloons, Dissolving Stents, FFR and More

Back to the FutureI added a new category “tag” to the stent blog today: “Back to the Future.” And I hereby declare this to be an internet meme, even if it’s only a meme on this site!

I added this category because every TCT or ACC or AHA or ISET or ESC or EuroPCR meeting that I cover, I am struck by the fact that the newest, latest, greatest innovations are all ideas that were present at the genesis of this field of interventional cardiology. Continue reading →

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Filed under Back to the Future, Drug-Eluting Stents, FFR, History, Meetings & Conferences, Peripheral Artery Disease (PAD), Video

December 1, 2012 · 11:17 pm

Ad Hoc Angioplasty: The Patient Is On The Table

Cardiologist and patient in cath lab

Cardiologist talks to a patient “on the table” in cath lab

Something that is “on the table” is defined as an item that is “up for discussion.” And this week The Society for Cardiac Angiography and Interventions (SCAI) issued a consensus statement about the proper use of “ad hoc PCI” — and the patient was definitely on the table, up for discussion, part of the conversation.

Since we’re into definitions, ad hoc PCI is the scenario in which a diagnostic catheterization is followed in the same session by PCI (angioplasty and stents). And this is a common scenario: in New York State, for example, 80% of all angioplasties are done in the same session as the diagnostic angiogram, although the vast majority of these are emergency or primary angioplasties, where a patient in the midst of a heart attack (or close to it) is brought into the cath lab and the blockage is opened up, saving the heart muscle and possibly the patient’s life. Continue reading →

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Filed under COURAGE, FAME I / FAME II, FFR, Heart Attack, History, Optimal Medical Therapy, Patient Empowerment, Patients, Shared Decision-Making, Stent

November 27, 2012 · 6:03 pm

Stents, Trials and Studies: What’s in a Word?

What's In a Word?Today the editors of the HEART Group Journals, comprising the Journal of the American College of Cardiology and other participating cardiovascular publications, issued a “Statement on Matching Language to the Type of Evidence Used in Describing Outcomes Data.”

Although the title of the article may be a bit yawn-inducing, the editors deserve a kudo or two for attempting to clarify reporting on medical issues. Continue reading →

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Filed under ACC, Appropriate Use Criteria (AUC), Clinical Trials / Studies, Drug-Eluting Stents, FDA, Media Coverage, Patients

October 30, 2012 · 8:54 pm

The Question of Angioplasty in the Elderly

We just posted a report on the XIMA Trial which studied stents in octogenarians. The trial compared drug-eluting with bare-metal stents and the results are very interesting: while the trial didn’t find a difference in these two types of stents for the pre-specified composite endpoint of death, heart attack, revascularization, stroke and major bleeding…it did find significantly lower incidence of revascularization and heart attack in those patients who received the drug-eluting Xience stent.

But the real take-away from the XIMA Trial is that stenting and angioplasty in the elderly is safe and effective. Mortality from cardiac causes in this trial was 4% at one year, no matter which stent was used. Continue reading →

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Filed under Antiplatelet Medications, Bare Metal Stents, Clinical Trials / Studies, Drug-Eluting Stents, Heart Attack, Meetings & Conferences, Patients, Stent, Video