Efforts to reduce discovery-to-balloon (d-to-b) and door-to-balloon times is sweeping the country as hospitals put in place new protocols and strengthen their ties with local emergency medical service personnel.
Ideally, patients stricken with ST-segment elevation myocardial infarction (STEMI) should receive a clot-busting drug like TPA (tissue plasminogen activator) within 30 minutes of onset of symptoms or undergo a balloon angioplasty within 90 minutes. Unfortunately, few hospitals have yet to achieve those optimum times. But they are getting better.

As new drug-eluting stents (DES) receive premarket approval (PMA) from the FDA, despite an abrupt downturn in the market, competition among platforms is expected to heat up. DES use will be further bolstered by positive reports on percutaneous coronary implant (PCI) procedures from the ARRIVE, SPIRIT II, COURAGE and CREATE clinical trials.
But do these new developments mean that concerns over late-stent thrombosis have been forgotten? Or will looming doubts stagger renewed adoption of DES in the clinical setting?
DES Market Swings

Many formerly invasive diagnostic and interventional cardiology procedures have migrated to less invasive or percutaneous options. The subsequent rise in cath lab procedures has increased the need for alternatives to manual compression that promote hemostasis at the access site, allowing for quicker patient ambulation and throughput.