January 26, 2021 — The U.S.
Stents Drug Eluting
This channel includes news and new technology innovations for drug eluting stents (DES). These drug coated stents were developed to solve a frequent problem with bare metal stents, which can cause neointimal hyperplasia (scar tissue growth) in some patients. The antiproliferative drugs used on DES prevent the growth of tissue. One downside of DES is the requirement for patients to take long-term antiplatelet therapy to prevent the possible formation of clots on these stents. Newer generation DES use technologies help the vessels heal faster, which may allow reduce the duration of dual antiplatelet therapy (DAPT), or use a single drug, usually eliminating aspirin. This section includes news for both metallic and bioresorbable drug-eluting stents and related clinical trial data.
Some of the device technologies discussed in the TCT 2020 late-breaking trial sessions. Top left, the Medtronic Resolute Onyx stent was the first stent to receive FDA clearance for short duration dual-antiplatelet therapy, which was a big topic and subject of several sessions. Lower left, the Keystone TriGuard 3 TAVR embolic protection device did not demonstrate superiority over TAVR without use of embolic protection. Top right, the Abbott MitraClip was the subject of two studies, including use to aid heart transplant patients. Bottom right, the Boston Scientific Acurate neo TAVR valve performed below the Sapien 3 and CoreValve Evolut.
Ori Ben-Yehuda, M.D., presenting the findings of the HOST-REDUCE-POLYTECH-ACS study at TCT 2020 that showed durable polymer drug-eluting stents (DES) performed better than the bioresorbable polymer DES that were supposed to replace them with the promise of being safer and lowering overall cardiac event rates.
The Boston Scientific Synergy stent uses a unique abluminal, bioresorbable drug-carrier polymer that dissolves after the vessel wall has healed months after the stent is implanted. Stent polymers have been implicated in cases of late-stent thrombosis, which required patients with DES to stay on dual antiplatelet therapy (DAPT). This study looked at using the device as a way to shorten DAPT duration.