At PCR, How Big is Small?
With each passing year, clinical trials reaffirm the efficacy of drug-eluting stents in reducing or eliminating restenosis. But the devices' success have raised concerns of a different sort: safety, and specifically, the risk of subacute and late stent thrombosis.
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Recent safety issues with drug-eluting stents may have opened the door ever so slightly for cardiac surgeons and coronary artery bypass graft (CABG) surgery to stage a small but noticeable comeback in the treatment of coronary artery disease.
Late stent thrombosis (LST) concerns associated with drug-eluting stents (DES) dominated sessions at the 2006 Transcatheter Cardiovascular Therapeutics (TCT) annual conference, with additional long-term data presented on this topic. The general feeling expressed was one of relief that the expanded dataset presented at TCT showed the LST problem was not as bad as some had feared when the issue was discussed at the World Congress of Cardiology (WCC).
Still feeling the reverberations of data released in Barcelona in September, this year's TCT meeting saw session after session on the risks of stent thrombosis from drug-eluting stents. While the data was clear--there is some risk, but not a lot--what to do about it was less clear. And the whole debate raises more questions than answers, for both interventionalists and cardiovascular device companies.