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Home » Stent News » October 4, 2006

Conor CoStar: New Stents May Be
Solution to New Stent Problems

October 4, 2006 -- Today's Wall Street Journal is running a story about Conor Medsystems and how the company may benefit from the current controversy over late stent thrombosis in drug-eluting stents. Angioplasty.Org has mentioned Conor and its CoStar drug-eluting stent on a number of occasions. It is not a new product, having been approved for use by the European Union in February of this year.

But the CoStar has taken on new meaning in the wake of reports from the World Congress of Cardiology meeting last month that showed a small, but higher rate of drug-eluting stent late stent thrombosis than had been reported in other studies to date. Late stent thrombosis occurs when blood clots form inside of stents more than six months after implantation. The cause has been debated, but seems to be the result of (1) patients not complying with their prescribed antiplatelet therapy (Plavix and aspirin); (2) physicians not prescribing that therapy for a long enough period; and (3) the polymer (plastic) coating on the stent which elutes the drug, but then remains permanently.

Pathologist Dr. Renu Virmani has performed autopsies on patients who had both drug-eluting stents and bare metal stents, and her observation was that the bare metal stents had been covered over by a smooth-celled endothelial layer, in effect hiding the stent from the clot-prone platelets in the bloodstream. But the drug-eluting stents she has seen have exhibited delayed healing and, in some cases, were still not covered over a year or more after implantation, thereby providing a catalyst for blood clots. It's thought that in some cases, the polymer may cause an inflammatory response or in some way keep the thin layer of smooth cells covering the stent.

The Conor Medsystems CoStar, and other emerging technologies in this field, take a different approach to drug-eluting stents. The CoStar is made with small depressions in the surface into which are loaded little droplets of a bioabsorble polymer, containing a drug which will impede scar tissue from growing inside the stent for the first few months. After the initial period, the drug has eluted, and the polymer droplets have been absorbed into the body leaving, in effect, a bare metal stent -- a device which will be covered over by the smooth arterial wall and, so it is thought, will not have the problem of late stent thrombosis.

Conor is not the only company working on this type of technology, but it is the only one to have come far enough to obtain European approval. One problem it faces is that the drug used in the CoStar is paclitaxel, the same drug Boston Scientific uses in its Taxus stent. The companies are currently involved in patent lawsuits and this may impede the CoStar. Also, according to the Wall Street Journal, Conor has had marketing problems in Europe stemming from "snafus" by its marketing partner Biotronik.

The Journal ends its article with an interesting thought -- perhaps Johnson & Johnson, a company that lost out in the Guidant acquisition battle with Boston Scientific, might be interested in new and emerging technologies like Conor. In fact, Angioplasty.Org reported in May that Cordis / Johnson & Johnson is establishing a new "Innovative Research Center" in Silicon Valley. Conor Medsystems is headquartered in Menlo Park -- the epicenter of Silicon Valley.


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