Drug-coated stents less risky for heart bypass patients

January 22, 2009

Coronary bypass surgery may carry less risk of serious complications if stents coated with a drug that suppresses cell growth are used in the procedure rather than bare-metal stents, UT Southwestern Medical Center researchers and colleagues have found.

The study, appearing online and in an upcoming issue of The Journal of the American College of Cardiology, is the first large, multicenter trial comparing two types of commonly used stents. Stents are small mesh tubes that reinforce the walls of blocked blood vessels. In this study, stents were used to treat blockages in diseased coronary arteries.

In bypass surgery, grafts are taken from the saphenous vein in the patient's thigh and sewn to the coronary arteries to help improve blood flow to the heart, relieve severe chest pain and reduce the risk of heart attacks from blocked arteries. Years after surgery, those grafts may develop blockages inside the graft that are challenging to treat because of high rates of recurrence.

"We wanted to see if one type of stent was superior in reducing the incidence of re-narrowing of the vein graft," said Dr. Emmanouil Brilakis, assistant professor of internal medicine at UT Southwestern and lead author of the study. "Stented vein grafts have a very high risk of re-narrowing - sometimes up to 50 percent when bare metal stents are used.

"Drug-eluting stents could provide a solution to this problem, but limited clinical results have been reported to date. The drug-eluting stents examined in our study are coated with a medication called paclitaxel, which inhibits cell growth."

The drug coating is contained on a polymer that covers the surface of the stents and eventually elutes, or washes out of the stent, over a period of several months or years.

In the study, researchers examined 80 patients, roughly half of whom had vein grafts with drug-eluting stents and the other half who had the same procedure with bare-metal stents.

Researchers found that 51 percent of patients with the bare-metal stent had re-narrowing of the vein graft over several months compared with 9 percent of the drug-eluting stent group. In addition, 28 percent of patients who had a bare-metal stent required another procedure to treat the same blockage, while only 5 percent of patients who had the drug-eluting stent did.

Some previous studies have indicated that patients receiving drug-eluting stents in saphenous vein grafts may not reduce the risk of re-narrowing and may be associated with increased risk of death, Dr. Brilakis said.

"Our findings suggest that drug-eluting stents are a better choice than bare-metal stents for this type of procedure," he said. "Patients receiving paclitaxel-eluting stents in our study were significantly less likely to have recurrence of their graft blockage and to require repeat procedures. The rates of death were similar in both study groups, although our study was not designed to detect differences in mortality."

The researchers now hope to repeat the study in an expanded group of patients, which would provide important data to determine definitively the efficacy and safety of each kind of stent.

Source: UT Southwestern Medical Center

Explore further: Diabetics get blood vessels made from donor cells

Related Stories

Diabetics get blood vessels made from donor cells

June 27, 2011

Three dialysis patients have received the world's first blood vessels grown in a lab from donated skin cells. It's a key step toward creating a supply of ready-to-use arteries and veins that could be used to treat diabetics, ...

Stem cell study aims to reduce amputations

March 9, 2011

UC Davis Vascular Center researchers have embarked on a highly anticipated study that involves using a patient's own stem cells to increase blood circulation to the lower leg with the hope of preventing amputation due to ...

Skin-cell spray gun drastically cuts healing time for burns

February 8, 2011

(PhysOrg.com) -- Scientists in the US have developed a new technique that sprays a burn patient's own cells on the burn to help regenerate the skin and drastically reduce recovery time. The gun has been under development ...

Scientists grow blood vessels for human surgery

February 2, 2011

Scientists can grow blood vessels in a lab for use in coronary bypass or dialysis, a promising alternative to harvesting from the patient, said a study published on Wednesday.

Recommended for you

How the finch changes its tune

August 3, 2015

Like top musicians, songbirds train from a young age to weed out errors and trim variability from their songs, ultimately becoming consistent and reliable performers. But as with human musicians, even the best are not machines. ...

Machine Translates Thoughts into Speech in Real Time

December 21, 2009

(PhysOrg.com) -- By implanting an electrode into the brain of a person with locked-in syndrome, scientists have demonstrated how to wirelessly transmit neural signals to a speech synthesizer. The "thought-to-speech" process ...


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.